Nursing Info - Sas16 23

Nursing Informatics
STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session 16
LESSON TITLE: INFORMATICS APPLICATIONS IN Materials:

EVIDENCE-BASED PRACTICE NCP & CLINICAL Pen and notebook
PATHWAYS
LEARNING OUTCOMES: References:

Calano, Roel B. & Del Rio, Fernando. (2017).
At the end of the lesson, you can: Health informatics: An illustrative approach (1st
1. Explain the use of the nursing process in making ed.)
computer generated nursing care plans;
2. Identify the different steps in nursing process; Saba, Virginia & McCormick, Kathleen. (2006).
3. Describe the characteristics of nursing process; and, Essential of nursing informatics (4th ed.).
4. Differentiate clinical pathways from clinical guidelines. McGraw-Hill Companies Inc.
LESSON PREVIEW/REVIEW
Answer this question: How would you describe the significance of telehealth and telenursing in rendering care to clients?
The significance of telehealth in rendering care to clients is that helps increase health care value and affordability. Virtual
care technology saves patients time and money, reduces patient transfers, emergency department and urgent care
center visits, and delivers savings to payers. On the other hand, telenursing is very convenient for the patients since it
allows patients to connect with their nurses through mobile devices, computers, mobile apps, video technology, and
remote patient monitoring. Nurses use a variety of tools when providing care through telenursing. They can send
information to their patients through apps or websites.
MAIN LESSON
You must study the contents of this lesson.
COMPUTER GENERATED NURSING CARE PLANS
A computer information system can either stand alone or be part of a larger system the whole facility uses. A
nursing information system (NIS) can increase efficiency and accuracy in all phases of the nursing process – assessment,
nursing diagnosis, planning, implementing and evaluating. It can help you meet standards of nursing practice and
documentation. In addition, an NIS can help you spend more time meeting patients’ needs. Consider the following uses of
computers in the nursing process.
A. Assessment
● Use the computer terminal to record admission information. As you collect data, enter further information as
prompted by the computer software program. Enter data about the patient’s health status, history, chief complaint
and other assessment.
● Some software programs prompt you to ask specific questions, then offer pathways to gather further information. In
some systems, if you enter a value that’s outside the usual acceptable range, the computer will flag the entry so
you can fix it.
B. Nursing diagnosis
● Most current programs list standard diagnoses with associated signs and symptoms as references. After you use
your clinical judgment to determine a nursing diagnosis for each patient, you can rapidly get information related to
the diagnosis.
This document and the information thereon is the property of PHINMA Education (Department of Nursing) 1 of 7
● For example, the computer can generate a list of possible diagnoses for a patient with certain signs and symptoms
or it may enable you to retrieve and review a patient’s records according to the nursing diagnosis.
C. Planning
● To help you begin writing a plan of care, newer computer programs display recommended interventions for the
selected diagnoses and expected outcomes. Computers also can track outcomes for large patient populations.
D. Implementing
● Use the computer to record interventions and patient information, such as transfer and discharge instructions, and
to communicate this information to other departments.
● Computer generated progress notes automatically
sort and print out patient data such as medication
administration, treatments, and vital signs, making
documentation more efficient and accurate
E. Evaluating
● You can use computers to compare large amounts
of patient data, help identify outcomes patients are
likely to achieve based on individual problems and
needs, and estimate the time frame for reaching
outcome goals.
● During evaluation, use the computer to record and
store observations, patients’ responses to nursing
interventions, and your own evaluation statements.
You also may use information from other health
care team members to determine future actions and
discharge planning. If a desired patient outcome
hasn’t been achieved, record new interventions
taken to ensure desired outcomes. Then reevaluate them.
● The construction of a plan of care for the patient is a collaborative process among the nurse, the patient, and other
health team members.
● The nursing process is used: o as a tool identify patients' problems and an organized method to meet patients'
needs oto identify and manage the health problems of clients o as framework for nursing care
● Distinct characteristics of Nursing Process

1. Within the legal scope of nursing 5. Goal directed
2. Based on knowledge 6. Prioritized
3. Planned 7. Dynamic
4. Client centered
● Standardized care plans are preprinted. Both computer-generated and standardized plans provide general
suggestions for managing the nursing care of clients with a particular problem. It is up to the nurse to transform the
generalized interventions into specific nursing orders and to eliminate whatever is
● Nursing process promotes critical thinking, creativity, problem solving, and decision making skills in clinical practice.
● Critical thinking- the process of objective reasoning; analyzing facts to reach a valid conclusion o ways to improve
critical thinking skills
▪ Effective reading
▪ Effective writing
▪ Attentive listening
▪ Effective communication o Apply the critical thinking process to a real-life problem to avoid
having your decision cause injury to anyone
CLINICAL PATHWAYS
A clinical pathway, also known as care pathway, integrated care pathway, critical pathway, or care map, is the main
tool used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that
their implementation reduces the variability in clinical practice and improves outcomes. Clinical pathways aim to promote
organized and efficient patient care based on evidence-based medicine and aim to optimize outcomes in settings such as
acute care and home care.
● Clinical pathways differ from clinical guidelines and protocols as they are a set of practical treatment processes
detailing how to implement clinical guidelines, including both clinical guidelines and non-clinical activities.
● Physicians use clinical pathways to give appropriate instructions on a daily basis. The nurses review the orders and
confirm their accomplishment. Other care team members such as the therapist, nutritionist, interns and clerks carry
out all the orders in the pathway pertaining to them.
● Patients’ progress in the pathway will be reviewed and the variances will be recorded by nurses and physicians.
● Pathways thus promote continuous improvement and reliable care. In addition, clinical pathways help in pursuing
the goals of improving patient care quality, maximizing the efficient use of resources and supporting clinical
effectiveness of health care staff.
● Instead of the isolated and error prone paper-based pathways, the computerized and shared pathway throughout
the treatment process will help in achieving a patient- centric process, improving care coordination and efficiency,
as well as reducing medical errors.
CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not allowed.
1. To initiate an intervention, the nurse must be competent in three areas, which include:
A. Knowledge, function, and specific skills
B. Experience, advanced education, and skills.
C. Skills, finances, and leadership.
D. Leadership, autonomy, and skills.
ANSWER: A
RATIO: The aim for the profession should be to improve practice by questioning findings from all sources. Gaining
knowledge raises an awareness of personal and professional accountability and the dilemmas of practice. Knowledge
is what improves care if the nurse is aware of the best knowledge or evidence to use in practice. On the other hand,
Nursing skills enable nursing professionals to efficiently and accurately care for other individuals, often those who are
sick or who cannot care for themselves.
2. A nurse is revising a client's care plan. During which step of the nursing process does such a revision take place?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
ANSWER: D
RATIO: The nurse determines if the set goals have been met and assesses the plan's performance during the evaluation
stage of the nursing process. Answer A entails data gathering. Answer B entails prioritization, while Answer C entails the
intervention itself.
3. The nurse performs an assessment of a newly admitted patient. The nurse understands that this admission assessment
is conducted primarily to:
A. Diagnose if the patient is at risk for falls.
B. Ensure that the patient's skin is intact
C. Establish a therapeutic relationship
D. Identify important data
ANSWER: D
RATIO: A thorough and accurate assessment is important because it helps differentiate the normal condition of the patient
from the abnormal. And, a comprehensive health assessment establishes if a patient needs diagnostic testing or additional
medical care.
4. The planning step of the nursing process includes which of the following activities?
A. Assessing and diagnosing
B. Evaluating goal achievement.
C. Performing nursing actions and documenting them.
D. Setting goals and selecting interventions.
ANSWER: D
RATIO: The planning stage is where goals and outcomes are formulated that directly impact patient care based on EDP
guidelines. These patient-specific goals and the attainment of such assist in ensuring a positive outcome. Nursing care
plans are essential in this phase of goal setting.
5. A multidisciplinary tool that indicates the usual interventions and expected outcomes in a definitive length of time for
management of a particular patient population in a specific setting
A. Practice Guidelines
B. Clinical pathway
C. Standard pathway
D. Nursing Process
ANSWER: B
RATIO: Clinical pathway is a multidisciplinary tool that indicates the usual interventions and expected outcomes in a
definitive length of time for management of a pt. population in a specific setting (often acute or sub-acute). gives background,
etiology, walks you through differential diagnosis, then gives you review of various treatment options and gives the overall
grade to all the studies used, then gives prognosis info and summarizes it all again.
6. Which of the following is a distinct characteristic of the nursing process?

A. Goal directed
B. Dynamic
C. Planned
D. All of the above
ANSWER: D
RATIO: Characteristics of the Nursing Process are; within the legal scope of nursing, based on knowledge, planned, client
centered, goal directed, prioritized, and dynamic.
7. What step in the nursing process wherein you determine the clients progress towards the attainment of expected
outcomes and effectiveness of nursing care?
A. Assessment
B. Planning
C. Evaluation
D. Implementation
ANSWER: C
RATIO: In the five-step nursing process, the evaluation phase is the final step involving conducting evaluative measures to
determine whether nursing interventions have been effective and whether the patient has met expected outcomes.
8. What is the first component of nursing diagnosis consisting of:
A. Etiology
B. Problem
C. Signs and symptoms
D. Related factors
ANSWER: B
RATIO: A nursing diagnosis has typically three components: (1) the problem and its definition, (2) the etiology, and (3) the
defining characteristics or risk factors (for risk diagnosis). Components of an NDx may include problem, etiology, risk factors,
and defining characteristics.
9. Which of the following are ways of improving critical thinking?

A. Effective reading
B. Attentive listening
C. Effective communication
D. All of the above
ANSWER: D
RATIO: Nurses play a critical role in patient care. A better ability to evaluate situations in front of you, make decisions based
on the information presented, and make the right decisions for patient care can all help you become a better nurse. Critical
thinking can be improved through effective reading, attentive listening, and effective communication.
10. Refers to the process of solving problems of patients and decision-making processes with creativity to enhance the
effect. It is an essential process for a safe, efficient and skillful nursing intervention.
A. Assessment
B. Diagnosing
C. Problem solving
D. Critical thinking.
ANSWER: D
RATIO: Critical thinking is applied by nurses in the process of solving problems of patients and decision-making process
with creativity to enhance the effect. It is an essential process for a safe, efficient and skillful nursing intervention.
LESSON WRAP-UP
You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.
You are done with the session! Let’s track your progress.
AL Activity: K-W-L
The letters KWL form an acronym for "Know, What, Learn." This is a strategy is an instructional technique used to improve
reading comprehension.
Fill up the following grids:

K – what you think you already know about this particular topic
W – you are encouraged to think about the gaps in your knowledge by filling out what you want to know
L – once the topic is completed, return to your grids to fill in the final ‘L’ column. Here, you confirm the accuracy of the first
two columns and compare what you have learned with your initial thoughts on the topic in the ‘K’ column.
K WHAT I KNOW
• The Nursing Process

• Distinct Characteristics of Nursing Process
W WHAT I WANT TO KNOW
• Computer Generated Nursing Care Plans
L WHAT I LEARNED
• I was able to learn about nursing process and its different phases. I was able to learn how generate nursing
care plans through computers. Lastly, I was able to learn about clinical pathways. I have learned that it is the
main tool used to manage the quality in healthcare concerning the standardization of care processes.
Nursing Informatics
Session 17
LESSON TITLE: Materials:

1. INFORMATICS APPLICATIONS IN Pen and notebook
EVIDENCE-BASED PRACTICE CLINICAL
GUIDELINES & E-JOURNALS
2. APPLICATION OF HEALTH INFORMATICS
CLINICAL PRACTICE
LEARNING OUTCOMES:
At the end of the lesson, you can:

3. Identify the purpose of clinical guidelines and its
characteristics;
4. Describe the four stages of clinical guidelines References:
development;
5. State the importance of e-Journals to nursing; Calano, Roel B. & Del Rio, Fernando. (2017).
6. Enumerate the advantages and disadvantages of Health informatics: An illustrative approach (1st
e-journals; ed.)
7. Differentiate past and present clinical practice;
8. Describe EMR, Telemedicine and e-Health; Saba, Virginia & McCormick, Kathleen. (2006).
9. Classify different subspecialties of telemedicine; and, Essential of nursing informatics (4th ed.).
10. Discuss the advantages and disadvantages of McGraw-Hill Companies Inc.
telemedicine.
Focused Listing: Concentrate on the key ideas or concepts in the lessons of the previous session. Review the list and after
you have finished this module, view the significance of these topics from the previous one.
• Computer Information System

• Nursing Information System
• Nursing Process
• Distinct Characteristics of Nursing Process
• Clinical Pathways
MAIN LESSON
CLINICAL GUIDELINES
● Clinical practice guidelines (or simply clinical guidelines) are recommendations on how to diagnose and treat a
medical condition. They are mainly written for doctors, but also for nurses and other health care professionals. ●
Clinical guidelines are systematically developed statements to assist practitioner d ● ecisions about appropriate
health care for specific clinical circumstances.
● Guidelines should be firmly based on reliable evidence relating to clinical effectiveness and cost-effectiveness, and
any recommendations should be linked to the evidence, with references and a grading of the supporting evidence.
● Guidelines can be used to reduce inappropriate variations I practice and to promote the delivery of high quality,
evidence based health care.
● The purpose of the guidelines is to improve the quality of care for patients and improve clinical effectiveness by
implementation of evidence based care in daily practice.
● Clinical guidelines can be developed either locally (internal guidelines) or regionally/ nationally (external guideline).
Although internal guidelines may need fewer resources and may be more likely to be adopted into clinical practice
because of local ownership, local groups may not have the skills required for guideline development. An alternative
is the development of guidelines at regional or national levels and subsequent modification to suit local
circumstances.
● Guideline development has four stages:

1. stage: It is essential that guidelines are based on the best available research evidence, and therefore
a detailed literature search is done to identify evidence from research studies about the appropriateness
and effectiveness of different clinical strategies.
2. stage: Using the research evidence, guideline construction takes place, usually through some form of
small group work, with representation from as many interested parties as possible.
3. stage: The guideline is tested by asking professionals not involved in the guideline development to
review it for clarity, internal consistency, and acceptability. The guideline can then be tested in selected
healthcare settings to see whether it is feasible for use in routine practice.
4. The guideline should be reviewed after a specified time period and modified to take into account new
knowledge.
● Eleven characteristics of the guidelines:

1. Validity means that if a guideline is followed it should lead to the health gains and costs predicted. This requires
that the guideline be rigorously developed and consistent with available scientific evidence.
2. Cost effectiveness means that the improvements in health care should have acceptable costs. If guidelines
ignore costs and concentrate only on benefits, practices might be recommended with major implications for
resource use, which are not accompanied by correspondingly large improvements in patient outcomes.
3. Reproducibility means that given the same evidence, another guideline development group would produce
similar recommendations
4. Reliability means that given the same clinical circumstances, another health professional would apply the
recommendations in a similar fashion; both are more likely to occur if the guideline is developed in a systematic
and rigorous manner.
5. Representative development: Guideline development should be undertaken by a group with representation
from all key disciplines and interests, including patients.
6. Clinical Applicability: For a guideline to be clinically applicable, the target population should be defined in line
with scientific evidence
7. Clinically flexible: by identifying exceptions and how patient preferences are to be taken into account in the
decision making process
8. Clarity: using precise definitions and user friendly formats
9. Meticulous documentation of the guideline development process should include details of who took part,
methods used, and assumptions made, and should link recommendations to the available evidence, which
should be graded according to its method
10. Scheduled review: Guidelines should also be reviewed periodically and modified to incorporate new knowledge.
11. Unscheduled review
E – JOURNALS
An electronic journal is a periodical publication which is published in electronic format, usually on the internet. E
journals have several advantages over traditional printed journals. You can search the contents pages and/ or the full text
of journals to find articles on certain subjects.
What is evidence based practice in nursing journals?
● Nursing students require education that integrates evidence- based practice (EBP) knowledge across classroom
and clinical settings. This study was conducted to identify and examine the literature related to nursing students use
of evidence in clinical education and to identify associated research gaps.
● Evidence-based nursing searches a wide range of medical journals applying strict criteria for the validity of research
and relevance to bet nursing practice.
Types or Variants of E-journals:

1. Classic electronic journals: Some of the electronic journals are available through internet applications, which are
also called classic e-journals. Originally they were distributed via email but now are available on the web and only
alerts of new issues are distributed by email. Access to this category of e-journals is free of cost.
2. Parallel electronic journals or Electronic version of print: These are journals that are available both in print and
electronically. Sometimes the electronic version may differ from the print journal e.g. article may appear
electronically before they are printed or the electronic version may have supplementary material on it. The website
offers previews and experts' view of issues. The online version may include the full text of the journal, only table of
content, or selected articles from print versions.
3. Database model and software model: Another type of e-journal is called database model and software model.
Under the database model articles reside in a centralized database maintained by the publisher and subscribers
are given permission to access the database to locate and download articles. The software would have an expiration
date that corresponds with the length of the subscription.
4. CD-ROM journals: Commercial publishers have also made journal titles available on CDROMs. The full text of
journals has been made available on CD-ROMs. In many cases these titles duplicate print titles already held by
libraries. Libraries have often subscribed to journals both in print and in CD-ROMs.
5. Full text: These are e-journals where complete articles are available rather than just summaries or abstracts.
Usually the whole of the journals is available online.
6. Electronic only journals: These are journals that are only available electronically, no counterpart like print or CD-
ROM is available of these types of journals.
Advantages of e-journals: The electronic formal offers many advantages to both users and publishers which paper
publications cannot match, they are:
1. Customization: Only the articles of interest are, “delivered” and the user has some control over the appearance of
the article both printed and on the screen.
2. Full text searching or navigation: Navigation and search are two of the most attractive features that an online
journal can offer. The retrieval capabilities of journals in electronic form are far better than those in paper. Every
word in the article is a potential retrieval point so that even a caption of a figure can be used to find a half
remembered article.
3. Speed of access: It takes some minutes or even seconds rather than hours or days to access. Much less time is
required to browse through electronic journals than print journals.
4. Speed and cost of publication: Avoiding the printing and mailing process can easily drop 2 or 3 weeks off the
current publication cycle. Machine readable text from the author is gradually lowering cost and reducing time as the
authoring and publishing system become better integrated and as electronic transmission is used more in the review
process. Hence, additional time will be saved.
5. Integration with other work: As the capabilities of computers grow, a situation is rapidly developing in which many
people do most of their work at personal computers. The two most important tools for scholars are probably e-mail
and word processing, but other activities, such as searching bibliographic databases, working with spreadsheets
and feeling and creating personal databases, are all being done with personal computers.
6. Economical: E-journal could be distributed more economically than print journals, because the main cost of
preparing the text, the review process and other such procedures are not as capital intensive as the costs of printing
and mailing print copies.
7. Hypertext links: Existing journal articles contain a large number of links both within the articles and to other articles.
They will gradually become useful links in the electronic version where a simple click on a reference will either lead
on to where it was cited, to an abstract of it, or to the article itself. As articles change in response to this sort of
capability, their organization may change into something more highly linked relying on the ability to easily follow
links to include reference to other articles or to other data sources.
8. Can be saved digitally: Saving the article as text, html, or PDF files is extremely easy and can be accessed any
number of times. Binding and other related activities does not arise.
9. No physical processing: Activities like accessioning, classification and cataloguing pertaining to print journal
subscription is completely avoided, and the time of the library staff can be saved.
10. Multimedia facility: Print journals have only text and two dimensional pictures. E-journals can include text, audio
and video images as well which help to easily understand the text.
11. Save physical storage: Generally, an electronic journal has no space restrictions, i.e. an e-journal can publish a
greater number of articles and lengthy articles compared with a print journal. No shelf space is required to store
them.
12. Search capabilities are tremendous: Search based on titles, keywords, author, subjects, abstract, article, full text,
can be executed to identify the journals and articles of interest by the user. Viewing an article’s abstracts from an
e-journal allows you to judge whether the article is worth using or not.
13. Multiple simultaneous access: E-journals can be simultaneously used by more than one user, which is possible
with print journals.
14. Less paper: Paper has many excellent qualities, but the electronic version of documents consumes fewer resources
and is easier to manage.
15. Availability: E-journals provide 24/7 accessibility and remote access to the user. No longer does the patron have
to come to the library to obtain a copy of the article as they are available at the same time for readers all around the
world, round the clock across geographical barriers, making them omnipresent.
Disadvantages of e-journals:
1. Difficulty in reading computer screens: The main disadvantage of electronic journals is the limitations of the
computer monitor. This leads to problems with reading, particularly over four or five screens. Long reading from the
screen can cause eyestrain.
2. Reliance on equipment: Unlike print journals, an electronic journal needs the availability of electricity, telephone
system, computers, internet, appropriate soft wares and hard wares etc. Though this is not the matter in the
developed countries, access to these can be a problem for developing countries.
3. Less permanent: Electronic versions of online journals are easy to lose and their reliance on soft wares and hard
wares makes them impermanent. This is a problem both for institutions such as libraries that might want to preserve
them and for individuals as well who wish to maintain their own collection.
4. Higher cost: The system needed to display and network needed to retrieve electronic articles are added cost to
the end user. Access to electronic articles is easier to monitor than to paper collections. Hence, there is more
possibility of publishers collecting free for use.
5. Complexities for acquisition: Acquiring electronic journals is in some way entirely more difficult than acquiring
print journals. There are license agreements to negotiate and librarians end up dealing with vendors whose
subscription rates and cost models aren’t always crystal clear.
6. Lower quality: Although recent e-journals may rival a photocopy of an article, few rival the original print publication,
especially on computer screens. These screens have lower resolution than paper and are usually smaller than two
pages of journals. Sometimes photographs are scanned incorrectly.
7. Frustrating interfaces: - Anyone who has used computers at all has encountered the frustration being incapable
of accomplishing a simple task. The same sort of thing can happen to conventional library users, but it is often less
obvious and frustrating, and very often there is someone available to ask what to do manual solutions are often
more obvious and easier to remember as well.
8. Requirement to log on: This is at least an annoyance and can lead to higher or at least more immediate costs.
Requiring a password also raises a barrier to use since it requires remembering it. There are also privacy issues;
electronic access is only private when designed to be so and publishers are obviously interested in what and how
much material is being used and to some extent and by whom.
9. Less material available: This is probably the most crucial problem. The source material is the key to any successful
library whether it is paper or electronic. Electronic bibliography databases have essentially achieved parity with their
paper versions in coverage, but full text journals cover only a small percentage of what is available in paper,
therefore you will still need to use other sources of information except electronic journals only.
10. Maintenance: E-journals provide many facilities but it takes more and expertise staff to maintain e-journal finders
Past Clinical Practice
● Data collected at bedside and the investigation reports entry, billing, was done manually.
● Not much emphasis on documentation. stored volumes records for referral purpose. ● Took days together to
finalize the diagnosis itself.
● Other than experience there was no confirmatory evidence to have a counter check.
● No records for research purposes on documented care.
Current Clinical Practice

● Computer generated client documentation:
o accesses, enters and retrieves client data related to client care via available hospital or nursing
information systems (demographic, vital signs, physiological data)
o uses computer applications to plan computer generated nursing care plans, order entry, results o uses
technology based client monitoring systems o uses information management systems for client
education o uses presentation applications to create slides, displays, overheads (PowerPoint, Corel
Presentation)
o operates peripheral devices (bedside and hand held) & automatic billing while nursing documentation
upholds ethical standards related to data security, confidentiality and clients' right to privacy
o reminders during documentation to aid charting o uses e-mail systems to communicate
● Quick accessibility regarding patient data from previous encounters reduces the waste of time.
● Experts system and Care maps guide the treatment plan. participates in the design and develop design
● Monitoring devices that record vital signs and other measurements directly into the client record (EMR)
● Computer generated care plans and critical pathways
● Automatic billing for supplies or procedures with nursing documentation
● Reminders and prompts appear during documentation to ensure comprehensive charting
Future Practice
● Future nurses will have sound knowledge in informatics science and experts in handling electronic devices in
planning, implementing, evaluating, and documenting the care which is evidence based care.
Managing Patient Records-Computerized Database: Managing Patient Records-Computerized Database ●

Patient data can be easily shared between doctors, pharmacies and other hospitals
● It is easy to search for and retrieve patient records
● Doctors can instruct a pharmacy to issue medication for a patient (no paper note needs to be written)
Monitoring of Patients
● Sensors are attached to the patient. Seniors are used to monitor: Pulse rate (heart beats per minute) Temperature
Breathing rate (breaths per minute) Blood oxygen levels Blood pressure
Application to Nursing Practice

● Work list to remind staff of planned nursing interventions
● Computer generated client documentation including discharge instructions and medical information
● Monitoring devices that record vital signs and other measurements directed into the client record
● Automatic billing of supplies of procedures with nursing documentation
● Reminders and prompts that appear during documentation to ensure comprehensive charting. ● Quick access to
computer-archived patient data from previous encounters ● Online drug information
Electronic Medical Record System

● Clinicians rely on complete and accurate data in order to make decisions about patient care
● Without a solid system for health information exchange in place between facilities, it is impossible to ensure that a
clinician has the entire clinical picture.
● Without complete historical information on a patient, treatment plans are often askew, which can mean suboptimal,
sometimes even lethal, outcomes
● Holds documentation of a single episode of care.
Disadvantages of Electronic Medical Record System
● Enormous start-up costs
● Nurses and doctors are unfamiliarity with technology
● Hackers may ultimately be able to penetrate system despite security precautions ● System is attacked by
computer viruses
● Power failure
EHR (Electronic Health Record) An electronic record composed of health information regarding an individual patient that
exists as part of a complete system designed to provide access to, and management of, such information. The EHR is
developed and managed by the health facility or provider. The term Electronic Health Record has largely replaced the older
“Electronic Medical Record.
● Historical Background of Electronic Health Records Recognizable efforts in the development of EHR are
distinguished by the Nicholas E. Davis Awards of Excellence Program whose history describes the improvement
of EHR in different settings. The Computer-Based Patient Record Institute (CPRI), founded in 1992. It was an
organization representing all the stakeholders in healthcare, focusing on the clinical applications of information
technology.
● It was among the first nationally based organizations to initiate and coordinate activities to facilitate and promote
the routine use of Computer-Based Patient Records (CPRs) throughout healthcare. Nowadays the Nicholas E.
Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and
has the following program objectives: The Healthcare Information and Management Systems Society (HIMSS) is
the healthcare industry's membership organization exclusively focused on providing global leadership for the
optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.
TELEMEDICINE
● Differences between telemedicine and telehealth
● Telemedicine: The use of medical information exchanged from one site to another via electronic
communications to improve a patient's health status.
● Telehealth: The use of electronic information and telecommunications technologies to support long-
distance clinical health care, patient and professional health-related education, public health and health
administration.
● Delivery of healthcare services, where distance is critical factor, by health-care professionals using
information and communication technologies for the exchange of valid information for diagnosis, treatment
and prevention of disease and injuries, and for the continuing education of health care providers as well as
research and evaluation, all in the interest of advancing the health of individuals and their communities.
(WHO)
● The oldest form of telemedicine is teleradiology (Form of telemedicine using computers and
telecommunications equipment that involves the sending of radiological images in digital form over
telecommunications lines.)
● Services for telemedicine
● Primary care and specialist referral service
● Remote patient monitoring
● Consumer medical and health information
● Medical education
● Types of telehealth interaction
● Store-and-forward: Images or videos are saved and sent later. Asynchronous communication
● Real time: A specialist views video images transmitted from a remote site and discusses the case with
another physician. Requires more sophisticated equipment: two ways interactive telemonitors permit the
specialist to see and talk to the patient
● Remote monitoring: Monitor patients at home or in a nursing home; usually part of disease management
● Tele consultants: Teleconsultation is a worldwide phenomenon because specialists tend to practice in large
metropolitan areas, and not in rural areas. Most programs consist of a central medical hub and several rural
spokes. The most commonly delivered services are mental health, dermatology, cardiology, radiology and
orthopedics
Objective of Telemedicine:
1. Move the information, not the patient
2. Replace transporting the patient or the specialist to a given location
3. Exchange of information, expertise for medical diagnosing and treatment is a basic concept
How is telemedicine used?

● Used as store-and-forward technology to transmit still images or interactive videoconferencing for real time
consultation.
What are the subspecialties of telemedicine?

1. Teleradiology: Telecommunicating radiological images. Can be store-and-forward. Can be real-time
2. Telepathology: Transmission of microscopic image over telecommunication lines allowing the pathologist to view
images on a monitor instead of under a microscope
3. Telecardiology: Echocardiograms could be telecommunicated
4. Teleneurology: permits a remote neurologist to read the CAT scan of the brain and see the neurological exam being
conducted on the patient
5. Telepsychiatry: Uses teleconferencing to deliver psychotherapy. May not be suitable for some types of mental
illness
6. Telestroke: Patients can be evaluated by expert miles away to see if they need tPA (A clot-busting drug which needs
to be administered within a few hours of a stroke.)
7. Telehome Care
8. Telespirometry: Used by asthma patients, information transmitted over telephone lines to remote location
9. Teledermatology: Is the practice of dermatology over telecommunications networks. Store-and-forward. Interactive
videoconferencing
10. Teleophthalmology: Is
using telemedicine to
study the eye
Other uses of Telemedicine

● Baby CareLink
● -RetCam to
diagnose retinopathy of
prematurity
● -Detecting Amblyopia in kids
● -Treatment of Alzheimer's (using
motion detectors to
monitor
patients)
● -In daycare
● -Weight management
● -Pain management
● -Spinal cord injury
● -Podiatry
Benefits of TELEMEDICINE
E-health
● use of the internet for the transmission of medical info. (mayoclinic, webmd) gain information on a condition ●
ehealth involves use of
● technology to transcend geographical distance in promoting good health ● use of information and
communication technologies (ICT) for health. ● Examples include:
● treating patients, ● educating the health
● conducting research, workforce, ● tracking diseases
and
● monitoring public health.
● In other words, E-health is the transfer of health resources and health care by electronic means. It
encompasses three main areas:
1. The delivery of health information for health professionals and health consumers through the Internet and
telecommunications.
2. The improvement of public health services using the power of IT and e-commerce, e.g. through the education
and training of health workers.
3. The use of e-commerce and e-business practices in health systems management.
1. These are recommendations on how to diagnose and treat a medical condition, they are systematically developed
statements to assist practitioner decisions about appropriate health care for specific clinical circumstances
a. Practical guidelines
b. Clinical guidelines
c. Systematic guidelines
d. Doctors Guidelines
ANSWER: B
RATIO: Clinical practice guidelines (or simply clinical guidelines) are recommendations on how to diagnose and treat a
medical condition. They are mainly written for doctors, but also for nurses and other health care professionals. Clinical
guidelines are systematically developed statements to assist practitioner decisions about appropriate health care for specific
clinical circumstances. Guidelines should be firmly based on reliable evidence relating to clinical effectiveness and cost-
effectiveness, and any recommendations should be linked to the evidence, with references and a grading of the supporting
evidence.
2. What is the first stage of developing a guideline?

a. It is essential that guidelines are based on the best available research evidence, and therefore a detailed
literature search is done to identify evidence from research studies about the appropriateness and
effectiveness of different clinical strategies.
b. Using the research evidence, guideline construction takes place, usually through some form of small group
work, with representation from as many interested parties as possible.
c. The guideline is tested by asking professionals not involved in the guideline development to review it for
clarity, internal consistency, and acceptability. The guideline can then be tested in selected healthcare
settings to see whether it is feasible for use in routine practice.
d. The guideline should be reviewed after a specified time period and modified to take into account new
knowledge.
ANSWER: A
RATIO: Guideline development has four stages: 1st stage: It is essential that guidelines are based on the best available
research evidence, and therefore a detailed literature search is done to identify evidence from research studies about the
appropriateness and effectiveness of different clinical strategies. 2nd stage: Using the research evidence, guideline
construction takes place, usually through some form of small group work, with representation from as many interested
parties as possible. 3rd stage: The guideline is tested by asking professionals not involved in the guideline development to
review it for clarity, internal consistency, and acceptability. The guideline can then be tested in selected healthcare settings
to see whether it is feasible for use in routine practice. 4th stage: The guideline should be reviewed after a specified time
period and modified to take into account new knowledge.
3. Which of the following terms describes the ability to access, evaluate and use electronic health information?
a. Health literacy c. Language literacy
b. Computer literacy d. None of the above
ANSWER: A
RATIO: Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health
information needed to make appropriate health decisions. Low health literacy is more prevalent among: Older adults.
Minority populations. Those who have low socioeconomic status.
4. A nurse is teaching a consumer about appropriate website selection which of the following consumer statements
indicates understanding of the teaching provided by the nurse
a. “I can print the information from the website and share it with my clients.”
b. “I will need to buy a new phone that has a lot of applications.”
c. "I will need to find websites that use appropriate terminology
d. “I will need to use a website that is readily available.”
ANSWER: C
RATIO: The usage of suitable vocabulary frequently shows that the website was created by a knowledgeable or trustworthy
firm.
5. Which of the following statements explains why it is important that nurses learn to evaluate electronic and published
health information?
a. “I can print the information from the website and share it with my clients.”
b. “I can improve my client’s outcomes by using current accurate information.”
c. “I can improve my client’s outcome by following the clinical guidelines.”
d. “I can use recent updates to help my client’s outcomes.”
ANSWER: B
RATIO: Responsible patient care: Data accuracy helps physicians at any practice to be informed of a patient's history,
tendencies, previous complications, current conditions and likely responses to treatment. It also allows quick treatment for
patients in the most efficient and appropriate way possible.
6. When using electronic medical records (EMR), the nurse knows that the EMR:
a. holds the documentation of a single episode of care.
b. is a longitudinal record of care for each patient.
c. is widely used for individual health care encounters.
d. includes progress notes for all disciplines.
ANSWER: A
RATIO: The electronic medical record (EMR), which is the documentation of a single episode of care (i.e., outpatient visit
or inpatient stay), becomes a part of the electronic health record (EHR), which is a longitudinal record of care. EHRs are
becoming widely used for individual health care encounters and for maintaining patients' health records over long periods.
As EHRs become fully implemented, they include provider order entries, progress notes for all disciplines, computerized
medication profiles, access to diagnostic test results on a timely basis, decision support systems, and online clinical
reminders and alerts.
7. Which type of records contain the most information?
a. Evidence base records c. Patient portal

b. Electronic medical record d. Electronic health
record
ANSWER: D
RATIO: An EHR is more than just a computerized version of a paper chart in a provider’s office. It’s a digital record that can
provide comprehensive health information about your patients. EHR systems are built to share information with other health
care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency
facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.
8. How can electronic medical records (EMRs) boost patients' engagement in their health?
a. Patients will not have to rely on doctors if they can seek medical advice through EMRs.
b. Patients will be more willing to work with their providers if they have to pay for access to a patient portal.
c. It helps patients become more aware of their own health status.
This document and the information thereon is the property of PHINMA Education (Department of Nursing) 10 of
12
d. All of the answer choices are correct.
ANSWER: C
RATIO: EHRs not only help physician but also are a patient's best companion. Patients can keep track, view, and manage
their records, appointments, prescriptions, doctor's notes all at one place. This puts a patient's trust in the healthcare system
and improves doctor-patient engagement.
9. Which of the following is a significant benefit of telemedicine?

a. Avoidance of transportation cost
b. Documentation requirements
c. Food and drug administration approval of devices
d. Privacy of home visit
ANSWER: A
RATIO: Telehealth is a valuable tool to connect people to a health care provider when there are barriers to accessing
transportation or it is not feasible to travel.
10. What is the oldest form of telemedicine?
a. Teleradiology c. Teleneurology
b. Telepathology d. Telestroke
ANSWER: A
RATIO: The oldest form of telemedicine is teleradiology. Telemedicine had the potential of giving immediate access to
specialists regardless of distance. Establishing a telemedicine site is so inexpensive that any clinic can afford it.
Telepsychiatry is the recommended therapy for anyone regardless of mental disorder.
LESSON WRAP-UP
AL Activity: CAT 3-2-1
This strategy provides a structure for you to record your own comprehension and summarize your learning. Let us see your
progress in this chapter!
Three things you learned:
1. Four stages of guideline development.
2. Characteristics of guidelines
3. Types or variants of E-journals.
12
Two things that you’d like to learn more about:
1. Advantages of e-journals.
2. Disadvantages of e-journals.
One question you still have:
1. What happens when patient’s data information is deleted from EHR (Electronic Health Record)?
12
Nursing Informatics
Session 18
LESSON TITLE: APPLICATION OF HEALTH INFORMATICS Materials:

ADMINISTRATION CLINICAL AND ADMINISTRATIVE Pen and notebook
HEALTH INFORMATION SYSTEM

1. Identify different systems under management ed.)
information system in health care;
2. Discuss the components, role and function of HIS; Saba, Virginia & McCormick, Kathleen. (2006).
3. Enumerate the advantages and disadvantages of NIS; Essential of nursing informatics (4th ed.).
and, McGraw-Hill Companies Inc.
4. Describe the use of HIS and NIS.
Answer this question: What is your own understanding of a technology in system?
Technology in system refers to the tools used to make the work fast and efficient. Healthcare technology refers
to any IT tools or software designed to boost hospital and administrative productivity, give new insights into
medicines and treatments, or improve the overall quality of care provided.
MAIN LESSON
MANAGEMENT INFORMATION SYSTEM IN HEALTH CARE
● System- A collection of components that work together to achieve a common objective

● Information System- A system that provides information support to the decision-making process at each level of
an organization. An arrangement of data, processes, people, and technology that interact to collect, process, store,
and provide as output the information needed to support an organization.
● Health Management Information System (HMIS)- An information system specially designed to assist in the
management and planning of health programmes, as opposed to delivery of care. Goal is to provide quality
information support decision making at all levels of the health care system in any medical institution ●
Characteristics of HMIS
1. Complete: it should provide information on all key aspects of the health system without duplication.
2. Consistent: if similar information is provided by different sources, their definitions need to be consistent.
3. Clear: it should be very clear what all the elements are actually measuring
4. Simple: not be unnecessarily complicated
5. Cost effective: the actual usage of each element should justify the costs of its collection and analysis
6. Accessible: form readily accessible to all legitimate users
7. Confidential: people without legitimate access are effectively denied
● Health Information System- A system that integrates data collection, processing, reporting, and use of the
information necessary for improving health service effectiveness and efficiency through better management at all
levels of health services. It is a computer system structured to manage all the records of health care providers to
make available information and reports useful to health care personnel in doing their job more efficiently. HIS was
introduced in 1960’s mainly used for billing and inventory
● Administrative Information System: Contains primarily administrative or financial data. Used to support the
management functions and general operations of the health care organization
● Patient Administration Systems (Administrative Apps) − Admission, discharge, and transfer registration
− Scheduling
− Patient billing or accounts receivable
− Utilization Management
● Financial Management Systems (Administrative Apps)
− Accounts Payable
− General Ledger
− Personnel Management
− Materials Management
− Payroll
− Staff Scheduling
● Ancillary Information Systems (Clinical Apps)
− Laboratory
− Radiology
− Pharmacy
● Physician Information System: this system is designed to improve the practice of physicians. EMRs & EHRs
● Radiology Information System: this system is capable of providing billing services and appointment scheduling
aside from reporting and database storage in the radiology department
● Pharmacy Information System: this system helps monitor the utilization of medicines in health institutions.
Handles information on medication-based complications and drug allergies of patients.
● Clinical Information System: used to collect and store information related to patient care
● Purpose of Patient Records
− Patient Care − Legal Documentation

− Communication − Billing and Reimbursement
− Research and Quality Management
● Content of Patient Records

− Identification Sheet − Imaging and X-Ray reports
− Problem List − Laboratory Reports
− Medication Record − Consent and Authorization Forms
− History and Physical − Operative Reports
− Progress Notes − Pathology Reports
− Consultation − Discharge Summary
HEALTHCARE INFORMATION SYSTEM (HIS)
Healthcare is a business and, like every business, it needs good management to keep the business running smoothly
Healthcare information systems means meticulously maintaining a patient's healthcare records and ensuring that
confidential information is securely kept. Those in healthcare information systems must have tremendous attention to detail
● Responsible for maintaining, updating, and securing all of a patient's healthcare information.
− Healthcare Service Providers who use HIM − Medical and diagnostic laboratories
− Hospitals − Dentists and dental clinics
− Nursing and residential care facilities − Home health care services
− Physicians and surgeons − Other health practitioners
− Other ambulatory health care service − Outpatient care centers
● Role and Function of Health Information Systems
− Files are easier to Access: The systems have revolutionized the collection and management of patient information.
The need for a hardcopy of the patient's medical records becomes optional as the systems are electronic.
− More and better controls: Only authorized personnel can have access information on the patient's health. Doctors
may be given permission to update patient information while a receptionist may only have the authority to update
a patient's appointments.
− Easy to Update: After the creation of the record, patient information can be accessed and reviewed at any time
and copies can be printed or released to the patient upon request.
− Improved Communication: HIS assists communication among doctors and hospitals. However, medical
professionals must adhere to regulations on patient privacy and security to ensure that information is kept
confidential and safe from unauthorized access
● Components of Health Information System According to Health Metrics Network (HMN)
− Health Information System Resources − Data Management
− Indicators − Information Products
− Data Sources − Dissemination and Use
● Health information systems resources
− These include the framework on legislation, regulation, planning, and the resources required for the system to
be fully functional. (e.g. personnel, logistics support, financing, ICT, and the component's coordinating
mechanism)
● Different Data Sources for Health Information Systems
1. Demographic Data: refers to the facts about the patient which include age and birthdate, gender, marital status,
address of residence, race, and ethnic origin.
2. Administrative Data: includes information on services such as diagnostic tests or our-patient procedures, kind
of practitioner, physician's specialty, nature of institution, and charges and payments
3. Health Risk Information: records the lifestyle and behavior of patients and facts about their family's medical
history and other genetic factors.
4. Health Status: refers to the quality of life that patients lead which is crucial to their health
5. Patient Medical History: gives information on past medical encounters like hospital admissions, pregnancies
and live births, surgical procedures, and the like
6. Current Medical Management: reflect the patient's screening sessions, diagnoses, allergies (esp. on
medications), current health problems, medications, diagnostic or therapeutic procedures, laboratory tests, and
counseling on health problems.
7. Outcomes Data: presents the measures of aftereffects of health care and of various health problems., outcomes
directly reported by patient after treatment will be most useful
HEALTH INFORMATION PROFESSIONALS

Health information management professionals plan information systems, develop health policy, and identify current and
future information needs They apply the science of informatics to the collection, storage, use, and transmission of
information to meet the legal, professional, ethical and administrative records-keeping requirements of health care delivery.
● Health information managers ● Health Information Administrator
● Medical records and health information ● Implementation managers
technicians ● Trainers
NURSING INFORMATION SYSTEM
● NIS has been defined as a part of a healthcare information system that deals with nursing aspects, particularly the
maintenance of the nursing record.
● one of the major clinical systems and allows for assessment of the patient and the documentation of the care and
teaching delivered.
● Supports the use and documentation of nursing processes and activities and provides tools for managing the
delivery of nursing care accurate patient charting, and better clinical data integration
● Goal of NIS
o Support and enhance nursing practice to improve access to information and tools
− online literature databases − hospital policy − drug information −
procedure guidelines
● What are some NIS and Documentations?
1. Nursing Process 3. Worklists
2. Flowsheets 4. Charting by Exception
5. Progress Notes
● Why is it important to have standardized Nursing Languages?
1. It is important to the development of electronic health record
2. measure nursing contributions
3. contribute to body of nursing knowledge ● The area of concern of nursing ranges from:
− clinical care of individual patients to the administration of health services
− the management of health problems at all levels of complexity
− including public health and community care
− occupational and home care
− school health
APPROACHES OF NIS
● Menu driven screens- It presents content in pre-arranged categories that allow practitioners to select the most
applicable items. The categories are designed around the nursing process from admission to discharge based on
the nursing diagnosis.
● Care Protocols- In this type of documentation, a specific protocol is selected based on the admission diagnosis.
The protocol lists the elements of care to be initiated and monitored during each patient day. The documentation is
related to the ability of the patient to achieve the established daily protocol goals.
GENERAL APPLICATION SOFTWARE FOR NURSE LEADERS

● Communication software – provides link for access between computer
● Database management system- for storing and retrieving data
● Word processing software- to produce documents such as memos, letters, signs, books and resumes.
● Spreadsheets- to develop budgets, maintain staff record, calculate, track and create graphs on statistics relating to
staff and patient data
● Personal Information Manager Applications – contains address book, calendar, email, a journal, notes and tasks.
Standardized NI -TERMINOLOGY
● Without a standardized nursing terminology, it would remain difficult to quantify nursing and the nursing component
of electronic health record systems would remain at best rudimentary. ANA has recognized 13 standardized nursing
languages
DATA ELEMENT SETS SETTINGS SETTINGS CONTENT
NMDS-Nursing Minimum Data Set All Nursing Clinical Data Elements
NMMDS-Nursing Management Minimum
All settings Nursing Administrative data elements
Data Set
CCC-Clinical Care classification All nursing care Diagnoses, Interventions and outcome
ICNP-International classification of
All nursing care Diagnoses, Interventions and outcome
Nursing Practice
NANDA All nursing Diagnosis All nursing Diagnosis
NIC-Nursing Intervention Classification All nursing Interventions
NOC-Nursing Outcome Classification All nursing Outcomes
Home care, Public Health and
OMAHA system Diagnosis ,Interventions, Outcomes
Community
PCDS-Patient Care Data Set Acute Care Diagnosis, Interventions, Outcomes
PNDS-Perioperative Nursing Data Set Perioperative Diagnosis ,Interventions, Outcomes
ABC-Alternative Billing Codes Nursing And Other Interventions
LOINC-Logical Observation Identifiers
Nursing And Other Out come and Assessments
Names and Codes
SNOMED CT-Systematic Nomenclature of
Nursing And Other Diagnosis ,Interventions, Outcomes
Medicine Clinical Terms
NIS: ADVANTAGES
● Increased observation due to forced recall
● Increased Accuracy and reliability of observations
● legibility with less time required to read and interpret accurately
● Decrease time in writing notes and better documentation
● Available for statistical analysis. Elements already coded can be selected. Teaching tool to client teaching and
students. 26
● Improved workload functionality: Staffing levels and appropriate skill mix per shift can be more easily determined
by the shift modules. This leads to less time spent in designing and amending rosters.
● Better care planning: Time spent on care planning is reduced, while the quality of what is recorded is improved.
This makes for more complete care plans and more complete assessments and evaluations.
● Better drug administration: Electronically prescribed drugs are more legible, thus making it less likely that drugs
would be wrongly administered to patients.
● Improved quality of care as a benefit of using IS, showing quality enhancements through the use of IS,
improvements in accessing patient information, obtaining prompt, complete and uniform patient information, and
processing patient admissions more efficiently.
● communication and documentation for exchanging data and information. These benefits can be examined using
bedside computer impact questionnaires, which evaluate the nursing documentation bedside computer system.
● compliance improvements with nursing documentation standards, charting consistency within the care plan, chart
availability and communication improvements among staff, nurses, patients and other care team members
● designed to help you reduce the cost of operating your nursing care divisions and also enhancing the quality of
patient care to the highest standards
● enable nursing staff to view lab results online, order specific tests which are required for patients, place drug indents
and automate various types of repetitive tasks which are required to be performed on daily basis
NIS DISADVANTAGES
● Charting may be longer due to need for review of content prior to selection
● Wording may not be common to a user's language. Standard Dictionaries are not readily available
● Pre-established content and need to make sure protocols are individualized for patients with comorbidities ●
Freedom of use vs security, lack of privacy
NIS CHALLENGES
● Criticisms of the actual system such as time consumption, inconvenient access, glitches, volume of data.
● Security issues i.e. health informatics law.
● Nursing issues, such as the notion that technology distracts nurses from providing quality individualized client care.
● Across the country the level of understanding of nursing informatics and its application to nursing practice is limited
● Change management resources required for informatics work is not well understood.
● Staff require dedicated time to complete competencies in informatics.
● There is a lack of clinical resources with the informatics experience.
● Need to increase understanding of the relationship between privacy acts. Breach of confidentiality and must work
with insurance and portability act guidelines and for universities the family education right and privacy act security.
Specifically, the applicable federal, provincial and territorial legislation
● Ergonomics Most common injuries- muscle and eye strain
● There is a need for data to be collected and coded using standardized terminology.
● Lack of professionals who understand the complexities of health information systems (HISs) and the health care
setting where they are deployed.
● lack of collaboration between disciplines and nursing. No curriculum that incorporates standard Nursing
Informatics Competencies License issues with tele-nursing ●
Copyright of materials on the web.
1. Which system is used to collect and store information related to patient care?
A. Clinical information system C. Financial management system
B. Ancillary information system D. Patient administration system
ANSWER: A
RATIO: A clinical information system (CIS) is an information system designed specifically for use in the critical care
environment, such as in an Intensive Care Unit (ICU). It can network with the many computer systems in a modern hospital,
such as pathology and radiology. Clinical Information System is used to collect and store information related to patient care.
2. Refers to an information system specially designed to assist in the management and planning of health
programmes, as opposed to delivery of care. C. Health information system
A. Health management information system D. Patient administration system
B. Administrative information system
ANSWER: A
RATIO: Health Management Information System (HMIS) is an information system specially designed to assist in the
management and planning of health programmes, as opposed to delivery of care. Goal is to provide quality information
support decision making at all levels of the health care system in any medical institution.
3. A system that integrates data collection, processing, reporting, and use of the information necessary for improving
health service effectiveness and efficiency through better management at all levels of health services.
A. Health management information system C. Health information system
B. Administrative information system D. Patient administration system
ANSWER: C
RATIO: Health Information System is a system that integrates data collection, processing, reporting, and use of the
information necessary for improving health service effectiveness and efficiency through better management at all levels of
health services. It is a computer system structured to manage all the records of health care providers to make available
information and reports useful to health care personnel in doing their job more efficiently. HIS was introduced in 1960’s
mainly used for billing and inventory.
4. Which of the following is the role and function of the health information system?
A. Easy access to files C. Improve communication
B. Better controls D. All of the above
ANSWER: D
RATIO: Role and function of Health Information Systems are: (1) Files are easier to Access: The systems have
revolutionized the collection and management of patient information. The need for a hardcopy of the patient's medical
records becomes optional as the systems are electronic. (2) More and better controls: Only authorized personnel can have
access information on the patient's health. Doctors may be given permission to update patient information while a
receptionist may only have the authority to update a patient's appointments. (3) Easy to Update: After the creation of the
record, patient information can be accessed and reviewed at any time and copies can be printed or released to the patient
upon request. (4) Improved Communication: HIS assists communication among doctors and hospitals. However, medical
professionals must adhere to regulations on patient privacy and security to ensure that information is kept confidential and
safe from unauthorized access.
5. Which of the following is not a component of the health information system?
A. Indicators C. Data management
B. Data sources D. Feedback
ANSWER: D
RATIO: Components of Health Information System according to Health Metrics Network (HMN) are health information
system resources, indicators, data sources, data management, information products, dissemination and use.
6. Refers to the facts about the patient which include age and birthdate, gender, marital status, address of residence,
race, and ethnic origin.
A. Administrative data C. Past health history
B. Demographic data D. Current medical management
ANSWER: B
RATIO: Demographic data refers to the facts about the patient which include age and birthdate, gender, marital status,
address of residence, race, and ethnic origin.
7. What is the goal of the nursing information system?

A. To manage health problems at all levels of complexities
B. Support and enhance nursing practice to improve access to information and tools
C. To develop electronic health record
D. Develop an effective nursing process for patients.
ANSWER: B
RATIO: The goal of NIS is to support and enhance nursing practice to improve access to information and tools such as
online literature databases, drug information, hospital policy, and procedure guidelines.
8. Which of the following is a disadvantage of nursing information systems?

A. Increased Accuracy and reliability of observations
B. Legibility with less time required to read and interpret accurately
C. Decrease time in writing notes and better documentation
D. Wording may not be common to user’s language
ANSWER: D
RATIO: Disadvantages of NIS are: (1) charting may be longer due to need for review of content prior to selection, (2)
wording may not be common to a user's language, (3) standard dictionaries are not readily available, (4) pre-established
content and need to make sure protocols are individualized for patients with comorbidities, (5) freedom of use vs security,
lack of privacy.
9. Reflect the patient's screening sessions, diagnoses, allergies (esp. on medications), current health problems,
medications, diagnostic or therapeutic procedures, laboratory tests, and counseling on health problems.
A. Outcomes data C. Health History
B. Demographic data D. Current medical management
ANSWER: D
RATIO: Current Medical Management reflect the patient's screening sessions, diagnoses, allergies (esp. on medications),
current health problems, medications, diagnostic or therapeutic procedures, laboratory tests, and counseling on health
problems.
10. Which of the following presents the measures of aftereffects of health care and of various health problems.,
outcomes directly reported by the patient after treatment will be most useful?
A. Outcomes data C. Health history
B. Biographical data D. Current medical management
ANSWER: A
RATIO: Outcomes data presents the measures of aftereffects of health care and of various health problems., outcomes
directly reported by patient after treatment will be most useful. Outcome data means any information relating to patient
survival or response, or progression, to assess the efficacy of a Compound or a Drug.
LESSON WRAP-UP
AL Activity: DAILY DOZEN
In this activity, choose two questions from a generic list to respond to about the main lesson of this session. Use the space
provided to accomplish this activity.
1. The thing that made the most sense to me today was…
2. One thing that I just don’t understand is…
3. When someone asks me what I did in math today, I can say…
4. One thing I would like more information about is…
5. I need more examples of…
6. I enjoyed…
7. The most important concept that I learned today was…
8. Today’s topic would have been even better if I had…
9. I was confused by…
10. The thing I did that best fit my learning style was…
11. The one thing I did today that worked well for me was…
12. The one thing I did today that did not work well for me was…
Answer:
4. One thing I would like more information about is the role and function of Health Information System.
7. Today’s topic would have been even better if I had more resources and it was discussed thoroughly through
virtual or face to face setting.
Nursing Informatics
Session 19
LESSON TITLE: EDUCATION Materials:

▪ E-LEARNING Pen and notebook
▪ E-NURSING
▪ TELECONFERENCING
▪ WEBINAR
LEARNING OUTCOMES:

1. Differentiate nursing education in the past and
present;
2. Define E-learning and E-nursing;
3. Classify the different delivery methods of E-learning; References:
4. Discuss the advantages and disadvantages of Calano, Roel B. & Del Rio, Fernando. (2017).
E-learning and E-nursing; Health informatics: An illustrative approach (1st
5. Identify the terms used in teleconferencing and ed.)
webinars;
6. Differentiate the types of video conferencing; Saba, Virginia & McCormick, Kathleen. (2006).
7. Discuss the advantages of a teleconference and Essential of nursing informatics (4th ed.).
webinar; McGraw-Hill Companies Inc.
8. Define webinar; and,
9. Implement ways on how to run a successful webinar.
Picture Prompt: Take a minute to look at the picture and process your thoughts. Afterwards, answer the question: How does
this relate to what you already know about this topic?
How does this relate to what you already know

about this topic?
- I think the pictures presented depicts on how

technology changed our traditional ways of doing
things. Modern technology has paved the way for
multi-functional devices like the smartwatch and
the smartphone. Computers are increasingly
faster, more portable, and higher-powered than
ever before. With all of these revolutions,
technology has also made our lives easier, faster,
better, and more fun.
MAIN LESSON
NURSING EDUCATION IN THE PAST

● Bedside learning tested all the procedures on the client.
● Faced the consequences of legal and ethical procedure.
● Teaching methods are lecture and demo, role play. used printed materials and notes of lecturers.
● Evaluation measures are manual and in front of clients and the public.
● More practical less theory. Practice by hospital oriented postings. Teacher student interaction is very professional.
CLASSROOM TEACHING
CURRENT NURSING EDUCATION

● 50% theory and remaining practice.
● Laboratory teaching gained importance. invasion of computers helped in teaching learning methods, admission,
resource sharing.
● Online study materials.
● Research reports.
● Emerging era of evidence-based practice with new learning.
● Simulation in teaching.
● Various teaching evaluation methods by technology ● Computerized record keeping ● Interactive video
technology.
● Distance learning- web based courses and degree programs.
● Internet resources- formal nursing courses and degree programs.
● Presentation software for preparing slides and handouts- powerpoints and MS words.
CLINICAL SIMULATION: LOW FIDELITY SIMULATORS
NURSING CARE CONFERENCE
LEARNING IN DIGITAL AGE
● Presentation software.
● Computer labs or resource centers,
● Computer assisted Instruction,
● teleconferencing
● Simulation labs with lifelike mannequins that mimic real patient scenarios and respond to nurses' interventions and
actions,
● Online registration, scheduling, attendance tracking, test administration and grade management of courses through
learning management systems
● Remote access to libraries or online publications
LEARNING IN DIGITAL AGE

● Learning occurs anywhere, any time through laptops, tablets, and smartphones. Courses may be completed at the
workplace, home, even at coffee shops. Variety of delivery options with greater flexibility for nurse managers
Accessibility, especially in rural area and Interactive video technology. Quality assurance and outcomes analysis
Nursing Education
HIGH FIDELITY SIMULATORS: HIGH FIDELITY SIMULATORS
VIRTUAL LEARNING
E- LEARNING
● E- learning involves the use of a computer or electronic device in some way to provide training, educational or
learning material.
● E-learning in Nursing
− Individualized self-paced e-learning online
− Individualized self-paced e-learning offline
− Group based e-learning synchronously
− Group based e-learning asynchronously
● Different forms/ delivery methods of E-learning
1. Asynchronous learning – Not time-bound, not taking place in real-time, e.g. discussion forums. Includes self-
study at a time that suits but within a timetable. Asynchronous learning allows learners to go through a course
at their own pace and on their own schedule. (fax, e-mail, knowledge base forum, quick reference guide)
2. Synchronous learning – Learners participate in an online learning experience at the same time or real time, but
in different locations. (telephone, screen saving, chat, skype conversation, desk type conferencing, online
seminar, google meet, zoom)
● Blended learning/ Hybrid Learning: An instructional approach that includes a combination of online and in-person
learning activities. For example, students can complete online self-paced assignments by a certain date and then
meet on-site or online for additional learning activities.
● Mobile Learning: takes place on a hand-held device (e.g., smartphone or tablet) at any time and from any place.
● Online Learning: includes any type of learning accomplished on a computer using the Internet.
● Self-Paced Learning: refers to a type of instruction that allows a person to control the flow of the instruction.
● Social Media Learning: refers to knowledge and skills gained through technologies that allow people to create
content and share information such as blogs and wikis.
● Importance of E-learning
− Decreased travel, reduced material and hopefully improving performance
− Decreased material cost
− Increase productivity
− Standardization
● Benefits of E-learning
− Enhances innovative teaching
− Promotes self-directed interactive learning
− Convenient for the leaner
− Save time, place for leaning
− Enhance data search by hyperlinks
− Aids to learn as and when learning
− Promotes internet use
− Builds responsibility and self-confidence among learners
● Advantages of E-learning
− Flexibility of learning, it is fast, no geographical barriers
− Wide range of opportunities for development of education
− Individual can have easy access
− E-learning has quality assured programs
− It is learner centered
− Effective in terms of material costs, travelling cost expenditure, travelling expenditure in achieving goals
● Advantages of E- learning to learners/students
− Accommodates everyone’s needs
− Lectures can be taken any number of times
− Access to updated content
− Quick delivery of lessons
− Scalability
− Consistency
− Reduced cost
− Effectiveness
− Less impact on environment
− Self-pacing
Disadvantages of E-learning
− Some forms of e-learning perceived as isolating from personnel touch
− Nurses may not have the IT skills needed to take advantages of e-learning −
Self-discipline
● Issues of E-
nursing −
Caring
− Empowerment
− Self-reflection, Expression
− Computer Literacy
− Confidentiality
− Networking
− Patient Education, Community Development, Cyber phobia
TELENURSING/ E – NURSING
● Use of telecommunications and information technology for providing nursing services in healthcare whenever a
large physical distance exists between patient and nurse, or between any numbers of nurses.
● E nursing involves the use of computers or electronic devices in some way to provide training, education and
learning material.
● E nursing comprises all forms of electronically supported learning and teaching. E nursing is being used in nurse
education and practice.
● GOALS OF E-NURSING: to enhance nurses to benefit from all developments in information, communication and
technology.
− To improve nursing and client outcomes.
− To encounter challenges owing to emergence of new technology.
● Objective of Telenursing
− To deliver care and expertise
− For curative, preventive and rehabilitation
− For training and information
● Types of Telenursing
− Synchronous (real time)
− Asynchronous (differed time) mode −
Direct (nurse-person encounter)
− Indirect (nurse-caregiver encounter
● Real-time (Synchronous) Videoconferencing Link
− Information – Distant – CPU, codec and decompressed – Incoming visual information displayed on monitor –
auditory information sent to the speakers.
● Telenursing technologies include activities such as
− Videoconferencing
− Medical imaging
− Data transfer
● Video Conferencing Benefits
− Faculty member keeps in touch with class while away for a week at a conference −
Guest lecturer was brought into a class from another institution.
− Researcher collaborates with colleagues at other institutions on a regular basis without loss of time due to
travel
− Schools with multiple campuses can collaborate and share professors.
− Faculty member participates in a thesis defense at another institution.
− Administrators on tight schedules collaborate on a budget preparation from different parts of campus ●
Factors promoting the requirement for Telenursing:
− Increasing shortage of nurses
− Costs of healthcare
●
− Need to provide Cost effective, timely and quality healthcare (remote, rural people). −
Rise in aging and chronically ill population
● Requirements for Telenursing
− Hardware – Telephone, PC or laptop computer
− For telehealth monitoring (power supply, web access)
− Software (LINUX)
− Software program (Cerner beyond now)
● Telenursing scope of practice
− Provider outlines assessment and follow-up care without the client having to travel to the health care agency
for an appointment
− Helps patients and families to be active participants in care −
One nurse can visit 12-16 patients in the same amount of time.
− Patients with chronic diseases are “visited” and assisted regularly by a nurse via videoconferencing, internet,
videophone, etc.
− For educating the clients −
Nursing Teleconsultation
− Examination of results of medical test and exams
● Advantages of telenursing
− Therapeutic touch
− Conferences, video can’t replace valuable time between nurse and patient
− Laws and a set code of rules and ethics will first need to be applied before telenursing can be used regularly
in various capacities. This alone might take some time
− It is costly due to cost of the monitor and equipment
− Equipment malfunction
− Inability for patient to use equipment
● Disadvantages of Telenursing
− Therapeutic touch
− Conferences, video can’t replace valuable time between nurse and patient.
− Laws and a set code of rules and ethics will first need to be applied before telenursing can be used regularly
in various capacities. This alone might take some time.
− It is costly due to the cost of the monitor and equipment.
− Equipment malfunction
− Inability for patient to use equipment
● Application of Telenursing
− Telephone consultation
− E-mail inquiries and advice
− Distance learning
− Video monitoring
− Digital photography
● Benefits of Telenursing
− Enhances patient care
− Reduces travel time
− Increases productivity
− Access to specialists
− Enlarged educational opportunities
● Uses of Telenursing
− Home care agencies
− Hospices
− Hospital based telemedicine center
− Managed care centers
− Rehabilitation Centers
− All branches of military
● Fastest growing application in telenursing
− Telephone triage
− Remote monitoring
− Home care
Terms usually used in teleconferencing

● Get the hang of something: become better at something after learning how to do it.
● Catch on: to understand.
● Landline: a fixed telephone line that runs through circuits in the ground.
● Headset: an earphone/microphone connection commonly used with telephone equipment.
● Hands free: describes an activity that does not require the use of one's hands.
● Receiver: part of the telephone used for listening and speaking.
● Conference bridge: a device that connects all telephone lines to one teleconference.
Hosting service: a company that provides teleconference services.
● Host/Call leader: the person in charge of the teleconference-in-progress.
● Call-in Number: the number that participants call to join a teleconference.
● Passcode: a series of numbers, like a password, that allow someone to participate in a teleconference.
● Punch: press buttons on the telephone.
● Roll call: a procedure to determine who is present at a meeting.
● So-and-so: a generic term for a hypothetical person used in an example.
● Mute button: a button callers use to temporarily silence themselves.
● Hold/put someone on hold: "hold" occurs when one person needs to step away from, but not disconnect, a telephone
call.
● Got it: a phrase meaning "I understand."
TELECONFERENCING
● Teleconferencing means telephone meeting among two or more participants through a
telecommunication medium. It is a generic term for linking people between two or more locations by
electronics. Teleconferencing means meeting through a telecommunications medium.
● Teleconferencing consists of a live real time session between multiple participants with the ability to
hear and see each other as well as share data and applications. Alternatively, teleconferencing can be
thought of as an aggregation of audio conferencing, video conferencing, and data conferencing (or
application sharing).
● Definition: “Teleconferencing is an aggregation of audio conferencing, video conferencing, and data
conferencing, and includes multiple participants in a live real-time session.”
● Types of Teleconferencing
Audio conference: involves transmission of voice only which are amplified at each end by the speaker system.
● It can usually be handled over regular telephone lines rather than needing a satellite as only voice will
be transferred.
● It’s the most cost effective type.
● Voice-only; sometimes called conference calling. Interactively links people in remote locations via
telephone lines.
● Audio bridges tie all lines together. Meetings can be conducted via audio conference.
Audio-graphic conference: employs voice plus graphic display capability.
● The most frequently used graphic supplement is a facsimile machine, which transmits electronically
and reproduces at remote locations anything that can be written/typed on paper.
● The additional cost of such operations is justified in cases where mathematical formulas and visual
diagrams are critical to understanding.
Video conference: Uses narrow band tele communications channels to transmit visual information such as graphics,
alpha-numeric, documents, and video pictures as an adjunct to voice communication. Combines audio and video
to provide voice communications and video images.
● Other terms are desk-top computer conferencing and enhanced audio.
●
● Devices include electronic tablets/boards; freeze-frame video terminals, integrated graphics systems
(as part of personal computers), Fax, remote-access microfiche and slide projectors, optical graphic
scanners, and voice/data terminals
● Can be one-way video/two-way audio or two-way video/two-way audio. It can display anything that can
be captured by a TV camera.
● The advantage is the capability to display moving images. In two-way audio/video systems, a common
application is to show people which creates a social presence that resembles face-to-face meetings
and classes and enables participants to see the facial expressions and physical demeanor of
participants at remote sites.
● Graphics are used to enhance understanding.
● Five basic components of a Video Teleconferencing (VTC) Network
1. video terminal - actual VTC unit
2. gatekeeper - switchboard/security
3. gateway - convert between codecs
4. Multipoint Conference Unit (MCU) - bridge multiple VTCs
5. proxy - a router in the techcon.
● There are three basic systems: freeze frame, compressed, and full-motion video. in this a television
type picture is transmitted through a mounted camera on T.V. and displayed along with the audio
message.
● The common format is to send out a full motion video presentation for example, a lecture speaker and
to receive back voice only from the recipient sites e.g. questions of the speaker. If full motion is not
necessary to get the point across, freeze frame, video consisting of a single frame of the presentation
can be transmitted at much less expense.
Computer conference: Uses telephone lines to connect two or more computers and modems.
● Anything that can be done on a computer can be sent over the lines. It can be synchronous or
asynchronous.
● An example of an asynchronous mode is electronic mail. Using electronic mail (E-Mail), memos,
reports, updates, and newsletters can be sent to anyone on the local area network (LAN) or wide area
network (WAN). Items generated on a computer which are normally printed and then sent by facsimile
can be sent by EMail. Some of the major online systems, like the source and CompuServe, have
established certain ‘areas’ of the network for an exchange of information among users on the particular
topic.
● This endeavor is known as electronic or computer conferencing and simply an extended, and more
intensive, form of electronic mail.
● There are two types of electronic conferencing:
a. Delayed time: it is closely resembling electronic mail. The conference takes place in a
simple shared ‘mailbox’ on the remote system.
b. Real time: conference is thoroughly interactive and more closely resembles a telephone
conference call- except that of course that communication is in ‘writing’. This type of conferencing
is especially useful among smaller groups of specialists who need to keep in frequent contact in
order to exchange ideas, share the latest information on research grants and contacts, or comment
on each other’s work.
Distance education: can be defined as any form of education in which the teacher and the learner are separated in
either time or space. Distance education was formerly called home study, and then correspondence education.
Later, distance education was delivered via radio and TV broadcast in different countries.
Advantages of teleconferencing
● Save Time: Content presented by one or many sources is received in many places simultaneously and
instantly. Travel is reduced resulting in more productive time. Communication is improved and meetings
are more efficient. It adds a competitive edge that face-to-face meetings do not.
● Lower Costs: Costs (travel, meals, lodging) are reduced by keeping employees in the office, speeding
up product development cycles, improving performance through frequent meetings with timely
information.
● Accessible: Through any origination site in the world. Larger Audiences: More people can attend. The
larger the audience, the lower the cost per person.
● Larger Audiences: More people can attend. The larger the audience, the lower cost per person.
● Adaptable: Useful for business, associations, hospitals, and institutions to discuss, inform, train,
educate or present.
● Flexible: With a remote receive or transmit truck, a transmit or receive site can be located anywhere.
● Security: Signals can be encrypted (scrambled) when it is necessary. Encryption prevents outside
viewers.
● Unity: Provides a shared sense of identity. People feel more a part of the group...more often.
Individuals or groups at multiple locations can be linked frequently.
● Timely: For time-critical information, sites can be linked quickly. An audio or point- to-point
teleconference can be convened in three minutes.
● Interactive: Dynamic; requires the user's active participation. It enhances personal communication.
When used well for learning, the interactivity will enhance the learning and the teaching experience.
● Enhances productivity
● It can be used both by educational institutions and corporations for group meetings and for instruction
(tele-training).
● It can prove an expert instructor to remote centers through teleconferencing.
● It offers uniform, quality controlled instruction to learners scattered over many or over a large area.
● It allows learners at multiple locations to interact with the instructor and with each other.
● It gives a large number of learner’s simultaneous access to fresh and accurate information.
● It provides in-service updating without leaving the work place.
● Ensures that the message gets through i.e. it is properly received, understood and assimilated.
● Teleconferencing is a very useful technology for telemedicine and telenursing applications, such as diagnosis,
consulting, transmission of medical images, etc., in real time in countries
Teleconferencing provides students with the opportunity to learn by participating in a 2-way communication platform.
● Teachers and lecturers from all over the world can be brought to classes in remote or otherwise isolated places.
● Students are able to explore, communicate, analyze and share information and ideas with one another.
Limitations
● Initial cost of equipment is very high
● Difficult for complex interpersonal communication ● Socializing is less than a face-to-face meeting.
● Although costs are falling, purchasing or reusing the needed hardware and paying the hourly rates for satellite
or telephone lines are still expensive.
● The complexity of the equipment involved raises many possibilities for disruptive technical malfunctions ●
True dialogue among the participants is impeded by the unfamiliar often intimating technology.
● The audience expectation broadcast quality presentation often leads to productions that impress but do not
instruct.
VIDEO CONFERENCING
● In telecommunication the term video conference has following meanings
1. A teleconference that includes video communication.
2. Pertaining to a two way electronic communications system that permits two or more persons in different
locations to engage in the equivalent of face to face audio and video communication
● Video conferencing technology allows two or more people at different locations to see and hear each other at the
same time. In addition, it is often possible to share computer applications such as internet pages, library catalogue,
documents, or software. This rich communication technology offers new possibilities for Schools College and
libraries including formal instruction (courses, lessons, and tutoring), connection with guest speakers’ expert, multi
school project collaboration, professional activities such as meetings and interviews and community events.
Types of Video conferencing
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1. Point to point conferencing: communication link between any two locations. Each site sees and hears the
other sites at all times
2. Multipoint conferencing: a link between varieties of locations. A video conference that connects to more than
two sites through the use of a multi-point control unit, or MCU. Participants at all sites can hear one another at
all times and see the site that is currently speaking.
Video Conferencing Components

● Cameras (to capture and send video from your local endpoint)
● Video displays (to display video received from remote endpoints)
● Microphones (to capture and send audio from your local endpoint)
● Speakers (to play audio received from remote endpoints) Two Additional Requirements:
● Codec - "compressor/decompressor “- makes the audio/video data "small enough" to be practical for sending over
expensive network connections. A codec takes analog signals, compresses and digitizes them, and
transmits the signals over digital phone lines.
● The Supporting System and the Network Connection
Various Uses of video conferencing

● Presentations
● Virtual meetings
● Videoconference-based learning
● JIT (just in time) events
● Recruitment/search committees
Benefits of Videoconferencing
● Can improve work quality
● Increase productivity
● Reduce costs
● Save money and time.
● General meetings Additional Uses:
● Project coordination
● Informal work sessions
● Alumni relations
● Question and answer sessions
18
●
Build relationships.
● Communicate “face to face” where it would otherwise be impossible.
● Avoid travels.
● Collaborate between teacher and learner • Improves communication
● Groups can meet more frequently
● Critical meetings can be convened in less time
● More faculty and staff can be involved
WEBINAR
● Webinar is the shortened version of the phrase “web-based seminar,” a webinar is a kind of web conference hosted
by one or more individuals (the presenters) and held online for an audience. A number of presentation methods can
be used in a webinar, including PowerPoint and live and pre-recorded video, and supplementary tools such as
screen sharing can be used for demonstrations.
How does a webinar work?

● A host (or multiple hosts) arranges a date and time for a
webinar; the topic is chosen ahead of time so attendees
know what the presentation will cover. Anyone can register
for the event on a landing page or with a specific code
given out by the organizer, and they can attend using their
browser. Alternatively, some attendees may attend by
calling in.
Using software designed specifically for hosting this kind of event,

the host presents to the audience. Features of webinar software
can include:
● The ability to edit the recording
● Phone-in options
● Screen sharing and remote access to an attendee’s computer
● CRM integration
● Moderation and question screening
● Live chat
● Surveys and polls
● Presentation options: Slides, video streaming, live video of the presenters, and more
How do you run a successful webinar?

As with any tool—email, social media, meetings, phone calls—your webinar must have a purpose. According to Beth
Hayden, follow these steps to run a more successful webinar:
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1. Instruction and learning occur not only in different locations, but also at different times. This form of E-learning is
referred to as which of the following?
A. Synchronous Learning
B. Asynchronous Learning
C. Blended Learning
D. Mixed Learning
ANSWER: B
RATIO: Asynchronous learning is not time-bound, not taking place in real-time, e.g. discussion forums. Includes self-study
at a time that suits but within a timetable. Asynchronous learning allows learners to go through a course at their own pace
and on their own schedule. (fax, e-mail, knowledge base forum, quick reference guide).
2. It is a mixture of face to face and online teaching.
A. Synchronous Learning C. Blended Learning

B. Asynchronous Learning D. Mixed Learning
ANSWER: C
RATIO: Blended learning/ Hybrid Learning: An instructional approach that includes a combination of online and in-person
learning activities. For example, students can complete online self-paced assignments by a certain date and thenmeet on-
site or online for additional learning activities.
3. Forms of education, instruction and learning that occur at the same time but not in the same place.
A. Synchronous Learning C. Blended Learning
B. Asynchronous Learning D. Mixed Learning
ANSWER: A
RATIO: Synchronous learning is a general term used to describe forms of education, instruction, and learning that occur at
the same time, but not in the same place. Synchronous learning means that although you will be learning from a distance,
you will virtually attend a class session each week, at the same time as your instructor and classmates. The class is a firm,
weekly time commitment that cannot be rescheduled.
4. Select all the advantages of eLearning for Learners

A. Accommodates everyone’s needs
B. Learn at their own pace
C. Access to updated contents
D. All of the above
ANSWER: D
RATIO: Advantages of E-learning to learners/students are; accommodates everyone’s needs, lectures can be taken at any
number of times, quick delivery of lessons, scalability, consistency, reduced cost, effectiveness, less impact on environment,
self-pacing.
This document and the information thereon is the property of PHINMA

Education (Department of Nursing) 13 of 18
5. With the spread of virtual schools and courses, some educators have expressed concerns about students: ___.
A. Overlearning materials
B. Losing the benefits of face-to-face contact
C. Engaging in excessive online game playing
D. Performing poorly on standardized tests
ANSWER: B
RATIO: In simple terms, face-to-face meetings are real to us while virtual meetings have the characteristic of being almost
real. This is because so much of communication is experienced through nonverbal cues. Face-to-face gives better
motivation to study; instant feedback. It is too difficult to learn everything through computer. Face-to-face interaction with
instructors is better for the learning process. Face-to-face is better for resolving study problems.
6. While talking with a client, a nurse determines that the client is participating in real-time telehealth based on the
understanding that this involves:
A. Teaching online
B. Instructor are not in the same place or working at the same time
C. Teaching offline
D. Same-time interaction of the client and provider via video.
ANSWER: D
RATIO: Real-time telemedicine (also called live telemedicine) makes it easy to do a doctor-patient visit anytime, anywhere.
Live telemedicine includes any two-way communications (including video conferencing and phone consultations) that let
providers and patients communicate in real-time.
7. A nurse is reading a journal article about the advantages and disadvantages of online learning. When reading the article,
which aspect would the nurse identify as a disadvantage? Select all that apply.
A. Isolation from personal touch
B. Technology skills
C. Self-discipline
D. All of the above
ANSWER: D
RATIO: Disadvantages of e-learning are; some forms of e-learning perceived as isolating from personnel touch, nurses
may not have the IT skills needed to take advantages of e-learning, and self-discipline.
8. Refers to the use of telecommunications and information technology (IT) for the delivery of nursing care.
A. Telehealth C. Telenursing
B. Telemedicine D. None of the above
ANSWER: C
RATIO: Telenursing refers to the use of information technology in the provision of nursing services whenever physical
distance exists between patient and nurse, or between any number of nurses.

●
9. What are the fastest growing applications of telenursing?
A. Home Care C. Both A & B
B. Telephone Triage D. None of the above
ANSWER: C
RATIO: The fastest growing applications of telenursing are telephone triage, remote monitoring, and home care.
10. Refers to a type of instruction that allows a person to control the flow of instruction
A. Self-paced Learning
B. Social-media Learning
C. Online Learning
D. Synchronous Learning
ANSWER: A
RATIO: Self-paced learning is defined as a specific learning method in which the learner is able to control the amount of
material they consume as well as the duration of time they need to learn the new information properly.
11. What type of learning occurs in real time?

A. Synchronous
B. Asynchronous
C. Virtual
D. None of the above
ANSWER: A
RATIO: Synchronous learning is any type of learning that takes place in real-time, where a group of people are engaging in
learning simultaneously.
12. Implies that people at different locations have audio, and possibly video, contact, which is used to carry out telehealth
applications.
A. Webinar
B. Seminar
C. Teleconferencing
D. Blog
ANSWER: C
RATIO: A teleconference is a live audio or audiovisual meeting with two or more participants. With the ability to
teleconference, remote teams in an organization can collaborate and communicate, even when geographically dispersed.
The process involves technology more sophisticated than a simple two-way phone connection.
13. Implies that people meet face-to-face and view the same images through the use of telecommunications and computer
technology even though they are not in the same location.
A. Audio conference
B. Video conference
C. Audio graphic conference
D. Computer conference
ANSWER: B
RATIO: Videoconferencing implies that people meet face-to-face and view the same images through the use of
telecommunications and computer technology even though they are not in the same location. For example,
videoconferences provide a means to improve quality and access to care in Alaska, where clinics are connected.

14. Which type of teleconference uses telephone lines to connect two or more computers and modems?
A. Audio conference
B. Video conference
C. Audio graphic conference
D. Computer conference
ANSWER: D
RATIO: Computer Teleconference uses telephone lines to connect two or more computers and modems. Anything that can
be done on a computer can be sent over the lines. It can be synchronous or asynchronous. An example of an asychronous
mode is electronic mail.
15. Which of the following is an advantage of teleconferencing?

A. Adaptable
B. Enhances productivity at a lower cost
C. Interactive
D. All of the above
ANSWER: D
RATIO: Advantages of teleconferencing are; it saves time, lower costs, accessible, larger audiences, adaptable, flexible,
security, unity, timely, interactive, and it enhances productivity.
16. Which of the following is used to capture and send video from your local endpoint?
A. Camera
B. Video display
C. Microphone
D. Codec
ANSWER: A
RATIO: A camera is a piece of equipment that is used for taking photographs, making films, or producing television pictures.
Many cameras are now included as part of other digital devices such as phones and tablets.
17. Refers to a device that connects all telephone lines to one teleconference.
A. Hosting service
B. Conference bridge
C. Call in number
D. Punch
ANSWER: B
RATIO: A conference bridge is basically a way for multiple people to join a single meeting. Conference bridges are
necessary when there are more than a few participants in a conference. Software used via a desktop app or even a web
browser can serve as a conference bridge.

●
18. A company that provides teleconference services
A. Hosting service
B. Conference Bridge
C. Telephone service
D. Teleconference service
ANSWER: A
RATIO: Hosted services are applications, IT infrastructure components or functions that organizations access from external
service providers, typically through an internet connection. Hosted services cover a wide spectrum of offerings, including
web hosting, off-site backup and virtual desktops.
19. This refers to a series of numbers, like a password, that allow someone to participate in a teleconference.
A. Personal Number
B. Secret pass
C. Passcode
D. Decoder
ANSWER: C
RATIO: Passcode is a sequence of digits used to gain access to a building, computer system, etc. Meaning, pronunciation,
translations and examples.
20. Which of the following is not a part of the basic system of videoconferencing?
A. Freeze frame
B. Compressed
C. Full motion video
D. Network
ANSWER: D
RATIO: There are three basic systems: freeze frame, compressed, and full-motion video. in this a television type picture is
transmitted through a mounted camera on T.V. and displayed along with the audio message.

LESSON WRAP-UP
AL Activity: STOP SUMMARY
This strategy provides a structure for you to record your own comprehension and summarize your learning. Complete the
following sentences:
Started the lesson with relating different pictures for today’s topic.
Topic was about E-learning, E-nursing, teleconferencing and webinar which were interesting and fun to learn.
Our Opportunities for practice were the different forms/delivery methods of E-learning since most of it applies to our new
learning set-up.
Purpose of the lesson was to differentiate nursing education in the past and present.
_________________________________________________________________________________________________

Nursing Informatics
Session 20
LESSON TITLE: COMPUTER APPLICATION THAT Materials:

SUPPORT NURSING RESEARCH Pen and notebook

1. Describe the steps on how to search effectively; ed.)
2. Use different reliable educational search engines;
3. Identify statistical tools used online; and, Saba, Virginia & McCormick, Kathleen. (2006).
4. Differentiate primary and secondary data sources. Essential of nursing informatics (4th ed.).
McGraw-Hill Companies Inc.
List three (3) educational search engines you have used and write at least 3 sentences about your experience in virtual
learning.
• Google – It is convenient to use. It provides quick answers to almost all of my queries. It is my most used search
engine.
• Ask.com – I usually use this when I can’t seem to find the right resources through Google. It is easy to use. It is an
innovative search engine.
• Bing – I seldomly use this search engine. Anyhow, it is convenient to use and also provide answers to my questions.
Its page layout is better than Google.
MAIN LESSON
COMPUTER APPLICATION THAT SUPPORT NURSING RESEARCH
1. Computerized literature searching- CINAHL, Medline and web sources.

2. The adoption of standardized language related to nursing terms-NANDA etc.
3. The ability to find trends in aggregate data, that is data derived from large population groups- SPSS.
Literature searches
● organized, systematic and thorough search of all types of literature in a certain topic ●
to complete thorough literature search you should:
− define what you are searching for
− decide where to search
− develop a search strategy
− refine your search strategy
− save your search for future use
Steps on how to search effectively

1. Identify search words or keywords
− Analyze your research topic or question o What are the main
ideas? o What concepts or theories have you already covered? o
Write down your main ideas, synonyms, related words or phrases
2. Where to search: database
− It is advised to search for several databases to make sure you do not miss a key paper related to your topic.
− Saved searches- in many databases you can save a search to run a later date particularly if your search
statement is complex and lengthy to enter.
3. Search techniques
− Once you have your keywords, combine them
− Boolean logic which allows you to link your search terms. It requires the use of Boolean operators AND,
OR and NOT
4. Evaluating information
− Evaluate the literature you find for quality and relevance
5. Organizing information
− When conducting a literature search recording the information you find in an organized manner is
essential. Literature searches require you to read and keep track of articles. Bibliographic management
tools can be used to help organize the references.
RELIABLE SEARCH ENGINES & DATABASES

● Database: it allows you to efficiently search for published information such as magazine, journal and newspaper
articles.
● Why use a Database?
− Reliable: many articles found in databases have undergone peer review process and generally more reliable
than information found on the internet, and it provides all the information you need to evaluate a source for
credibility (such as publication details and author’s name)
− Relevant: databases allow you to customize your search to get the most relevant result. Search for keywords,
terminology, subject headings and descriptors. You can also search by author or title.
− Accessible: databases often provide access to the full text of an article so you do not need to go to the library
to retrieve it in person. Also allows us to access information at no charge.
● Search engines such as google use computer algorithms to search the internet and identify items that match the
characters and keywords entered by the user.
● Why use a search engine?
− They are useful for finding information produced by Governments, Organizations, groups and individuals.
● Google: the most popular search engine in the world; offers a large Web page catalog. Developed by Larry Page
and Sergey Brin in 1996. They created the "back rub" strategy which meant that a search would prioritize the results
by ranking the page that is linked the most first (page ranking).
● Bing: offers related search ideas and search suggestions as you type in the search bar; can say how many results
you'd like displayed on one page
● Yahoo: provides advanced search options, preferences settings, and search suggestions
● Human powered search engines: ChaCha and MAhaloRefSeek: more than 1 billion books, encyclopedias, journals,
Web resources, and newspapers
● Academic Index.net: scholarly index of Web resources selected by librarians and academic professionals
● Search.com: identifies the search engine along with its results and offers both Web-wide searches and a wide
variety of specialty search options. operated by CBS Interactive
● Dogpile.com: searches Google, Yahoo!, Yandex, and more and identifies search engines along with its results.
sends a search to a customizable list of searches.
● DuckDuckGo.com: searches a number of crowd-sourced websites including Bing, Yahoo!, and Yandex, and
presents search results in order of most relevant content, rather than most popular content
● Noodle Tools: educational tools, software, and information for students; guidance on when to use what search
engine
● TeachThought's 100 Search Engines for Academic Research: a list of all-purpose, job-related, and subject-specific
search engines, information about databases and archives; as well as books and journals; informational sources
concerning maps, news, multimedia, legal issues, open-source materials, schools, and more
● Other Educational search engines

− Google scholar: scholarly resources, including articles and theses, that span countless disciplines
− Google books
− Microsoft academic
− WorldWideScience
− Science.gov
− Wolfram Alpha
− Refseek: books, encyclopedias, journals, web resources, newspapers
− Educational Resources Information Center
− iSeek: more than 100,000 sources from universities, the government, and noncommercial providers −
ResearchGate
− BASE
− Infotopia
− PubMed Central
− Lexis Web
How do search engines work?

1. crawl: automated spiders browse websites and build list of keywords
2. index: select info is sent to the search engines database to be indexed 3. match: entries in the
database are matched when users conduct searches.
4. locate: pages containing page(s) searched for are located
5. display: pages are sorted and ranked by relevance on a page
DATA COLLECTION & STATISTICAL TOOLS
TYPES
A. Quantitative data: data that is expressed in numbers and summarized using statistics to give meaningful information
B. Qualitative data: when we use data for description without measurement. Data can’t be easily summarized using
statistics.
SOURCES OF DATA
A. Primary data: obtained directly from individuals, objects or processes.
o Advantage: no customizations needed to make the data usable
o One can control how the data is collected
B. Secondary data: when you collect data after another researcher that initially gathered
Examples of Primary Data Sources
● Data and original research ● Autobiographies and

● Diaries and journals memoirs
● Speeches and interviews ● Government documents
● Letters and memos ● Census statistics
Secondary data sources

● Encyclopedias ● Most journal activities
● Chronologies ● Abstracts of articles
● Biographies ● Paraphrased quotations
● Monographs
STATISTICAL TOOLS
Statistical methods are mathematical formulas, models, and techniques that are used in statistical analysis of raw
research data. The application of statistical methods extracts information from research data and provides different ways to
assess the robustness of research outputs.
A. On-line Questionnaires: these are designed through the careful construction of questions to identify facts and
opinions from specific groups of respondents. Using a questionnaire to gather research data is often an attractive
proposition as they are arguably more precise and focused than alternative methods such as interviewing and
observation by researchers.
● Advantages
− Inexpensive − Comparability
− Practical − Easy analysis
− Fast result − Validity & Reliability
− Scalability − No pressure
● Disadvantages
− Dishonest answers
− Interpretation issues
− Accessibility issues
B. Digital Polls: (AKA online poll) allows participants to communicate responses via the internet, typically by completing
a questionnaire in a web page.
● May allow anyone to participate OR may be restricted to a sample drawn from a larger panel.
● Allows one to ask a single multiple choice question. Participants can choose among predefined answers (can be
restricted to one answer or multiple answers).
● Advantages: opinion polls are a way of estimating public opinion on a certain matter. In nursing research, digital
polls are useful for assessing probable public reaction to all illness, medical procedure, method, plan, or product.
− Can reach a wider audience
− Easier for people to respond to and access
− Instant delivery of results
− Ease of processing and display (graphs, bar charts, and other diagrams and graphics to display result)
C. Survey monkey
● SVMK Inc., doing business as SurveyMonkey, is an online survey development cloud-based software as a service
company.
● It was founded in 1999 by Ryan Finley and Chris Finley.
● The company provides surveys, and a suite of paid back-end programs.
● How does survey monkey work?
Gather opinions and transform them into People Powered Data (PPD) 1.
Easily create surveys, quizzes, and polls for any audience.
2. Gather feedback via web link, email, mobile chat, social media, and more.
3. Automatically analyze your results and get powerful analysis features.
4. Export your results or integrate your data with your favorite apps.
5. Use your insights to make better, data-driven decisions. ● How does it improve healthcare?
1. Supports patient-provider communication by getting feedback
− Measures employee satisfaction
− Monitor patients’ health and safety habits
− Probe the efficacy of patient safety culture
2. Helps gather and analyze more information faster
− Custom health surveys, or rely on expert templates
− Distributes surveys more efficiently
− Platform to analyze the results and export professional charts
● Types of Healthcare surveys
1. Patient satisfaction- quality: doctors, staff, facilities
2. Employees and staff- engaged org.; training and tools.
− Employee engagement
− Patient safety culture
− Training feedback and incident reports
− Event and meeting feedback
− Performance evaluation and reviews
− Exit interviews and other HR surveys
3. Medical research: specific population and /or vs others
4. Set benchmarks: point of reference = specific improvement

1. What is the first step on how to search effectively?

A. Where to search database
B. Search techniques
C. Identify search words or keywords
D. Evaluating information
ANSWER: C
RATIO: The first step on how to search effectively is to identify search word or keywords. You should analyze your research
topic or question. Identify the main ideas, concepts or theories you have learned as well as your main ideas, synonyms,
related words or phrases.
2. If you choose a topic for a multiple-page research paper that is too broad or vague, you will likely
find:
A. very little information
B. too much information
C. just enough information
D. None of the above
ANSWER: B
RATIO: Information overload describes the excess of information available to a person aiming to complete a task or make
a decision. Information overload can lead to many disadvantages such as it can cause our brain to become less productive,
easily get tired and distracted. There are several ways a student or a researcher can do to manage information and make
a better use of internet resources in order to avoid information overload.
3. Allows you to efficiently search for published information such as magazine, journal and newspaper articles.
A. Database
B. Search engine
C. Google
D. Yahoo
ANSWER: A
RATIO: A database is an organized collection of structured information, or data, typically stored electronically in a computer
system. A database is usually controlled by a database management system (DBMS).
4. Refers to a systematic and well-organized search from the already published data to identify a breadth of good
quality references on a specific topic.
A. Literature searches
B. Google search
C. Yahoo search
D. Bing Search
ANSWER: A
RATIO: Literature search is a systematic and well-organised search from the already published data to identify a breadth of
good quality references on a specific topic.The reasons for conducting literature search are numerous that include drawing
information for making evidence-based guidelines, a step in the research method and as part of academic assessment.
However, the main purpose of a thorough literature search is to formulate a research question by evaluating the available
literature with an eye on gaps still amenable to further research.
5. If you choose a topic for a multiple-page research paper that is very specific or new, you will likely find:
A. very little information C. just enough information
B. too much information D. none of the above
ANSWER: A
RATIO: A topic is very specific or new if you can't find any information about it. Though student writers most often face the
challenge of limiting a topic that is too broad, they occasionally have to recognize that they have chosen a topic that is too
narrow or that they have narrowed a workable topic too much.
6. What type of resource is written by an expert in a particular field, reports on scholarly research, and includes a list of cited
references at the end?
A. Journal article C. Encyclopedia article
B. Magazine article D. Newspaper article
ANSWER: A
RATIO: Journal articles are shorter than books and written about very specific topics. A journal is a collection of articles (like
a magazine) that is published regularly throughout the year. Journals present the most recent research, and journal articles
are written by experts, for experts.
7. Periodical articles come from: (Select one) C. Newspaper

A. Journals B. Magazines D. All of the above
ANSWER: D
RATIO: Periodicals are materials that are published at regular intervals (monthly, quarterly, daily, etc.) Periodical articles
contain current information, which is especially important in fields such as science, business, psychology, and technology.
8. Review the citation below. Select the source that it comes from:
"Does Reality Backbite? Physical, Verbal, and Relational Aggression in Reality Television Programs." By Coyne, Sarah M.;
Robinson, Simon L.; Nelson, David A. Journal of Broadcasting & Electronic Media, Apr2010, Vol. 54 Issue 2, p282-298,
17p, 3 Charts.
A. Book C. Popular magazine
B. Newspaper D. Scholarly journal
ANSWER: D
RATIO: A type of periodical that includes original research articles written by researchers and experts in a particular
academic discipline, providing a forum for the production and critique of knowledge. For all online scholarly journals, provide
the author(s) name(s), the name of the article in quotation marks, the title of the publication in italics, all volume and issue
numbers, and the year of publication. Include a DOI if available, otherwise provide a URL or permalink to help readers locate
the source.
9. Review the article citation below. Select the source that it comes from:
"THE Wild, the Stupid & the Jersey Shore Shuffle." By Eliscu, Jenny. Rolling Stone, 8/5/2010, Issue 1110, p54-57, 4p, 2
Color Photographs.
A. Popular magazine C. Newspaper
B. Book D. Scholarly journal
ANSWER: A
RATIO: To cite a popular magazine, it should be written starting with the Author's Last Name, First Name Middle Name or
Initial. “Title of Article.” Name of Magazine, volume number, issue number, date of publication, page numbers. Example:
Rowell, Melody.
10. What is the most popular search engine in the world?

A. Google C. Bing
B. Yahoo D. Firefox
ANSWER: A
RATIO: Google is the most frequently used search engine worldwide. But in some countries, its' alternatives are leading or
competing with it to some extent. As of the third quarter of 2021, more than 59 percent of internet users in Russia used
Yandex, whereas Google users were nearly 40 percent.
LESSON WRAP-UP
AL Activity: CAT 3-2-1

This strategy provides a structure for you to record your own comprehension and summarize your learning. Let us see your
progress in this chapter!
Three things you learned:
1. Steps on how to search effectively.
2. Identifying reliable and educational search engines.
3. Differentiating primary and secondary sources.
Two things that you’d like to learn more about:
1. How to cite scholarly journals properly.
2. Other examples of secondary data sources.
One question you still have:
1. N/A
Nursing Informatics
Session 21
LESSON TITLE: DATA PROCESSING & DATABASE Materials:

APPLICATION Pen and notebook

1. Define data processing and database application; ed.)
2. Explain the importance of Database management
system; Saba, Virginia & McCormick, Kathleen. (2006).
3. Enumerate the steps in database life cycle; and, Essential of nursing informatics (4th ed.).
4. Differentiate Spreadsheets, SPSS, SAS & In Vivo. McGraw-Hill Companies Inc.
Answer the question: What do you understand about data processing?
Data processing, manipulation of data by a computer. It includes the conversion of raw data to machine-readable form,
flow of data through the CPU and memory to output devices, and formatting or transformation of output. Any use of
computers to perform defined operations on data can be included under data processing.
MAIN LESSON
You must study the contents of this lesson
DATA PROCESSING,
● Manipulation of data by a computer. It includes the conversion of raw data to machine-readable form, flow of data
through the CPU and memory to output devices, and formatting or transformation of output. Any use of computers
to perform defined operations on data can be included under data processing.
DATABASE APPLICATION
● is computer software which allows one to enter, update, read and delete data from a database.
● It is a computer program whose primary purpose is entering and retrieving information from a computerized
database.
● Early examples of database applications were accounting systems and airline reservations systems, such as
SABRE, developed starting in 1957.
DATA/ INFORMATION:
● are raw uninterrupted facts that are without meaning.
● When data is interpreted, information is produced. While data is meaningless, information by definition is
meaningful. For data to be interpreted and information produced, the data must be processed.
Some common approaches in organizing data:
●Sorting ● ● Summarizing
Classifying ● Calculating
DATABASE
● This is an organized collection of related data.
● This is a collection of information that is organized so that it can easily be accessed, managed, and updated.
● A common paper example is PHONEBOOK; A much more complex example can be a PATIENT’S MEDICAL
RECORD
Factors of finding information in databases:

● How the data are named (indexed) and organized.
● The size and complexity of the database.
● The type of the data within the database.
● The methodology or tools used to search the database
Information system
● are used to process data and produce information.
● it is often used to refer to computer systems, but this is only one type of information system. There are manual
information systems as well as human information systems.
Human Brain
● is the most effective and complex information system.
Types of computer data

1. Computer-based data types: this classification is used to build the physical database within the computer system. It
identifies the number of spaces needed to capture each data element and specific function that can perform on
these data.
● Alphanumeric data – include letters and numbers in any combination.

− Social security number – is an example of alphanumeric data made up of numbers.
− Memo - is a specific type of alphanumeric data with increased spaces and decreased indexing option.
● Numeric data – are used to perform numeric functions including adding, subtracting, multiplying and dividing. It can
be long integer, currency or scientific.
Date and time - are special types of numeric data with which certain numeric functions are appropriate.
− Logic Data: Are data limited to two options. Ex: yes or no; true or false
2. Conceptual data types : reflect how users view the data, these can be based on the source of the data −
Example: the lab produces lab data, and the x-ray department produces image data.
o It can also be based on the event that the data are attempting to capture. o Examples of
data that reflect event capturing: assessment data, intervention and outcomes data.
One of the major advantages of an information system is that each of these data elements can be captured once and used
many times by different purposes, this is referred to as “DATA COLLECTED ONCE, USED MANY TIMES.”
DATABASE MANAGEMENT SYSTEMS (DBMSs)
● are computer programs used to input, store, modify, process and access data in a database. Before the DBMS can
be used, the DBM software must first be configured to manage the data specific to the project. This process of
configuring the database software is called DATABASE SYSTEM DESIGN.
A functioning DBMS consists of three (3) interacting parts:

● The data
● The DBMS configured software program
● The query language used to access the data.
SOME EXAMPLES OF DBMS:

● Computerized library systems ● Flight reservation systems
● Automated teller machines
ADVANTAGES OF AUTOMATED DATABASE MANAGEMENT SYSTEM:
● Decrease data redundancy
● Increase data consistency
● Improve access to all data
TYPES OF FILES
1. PROCESSING FILES: Executable files consist of a computer program or set of instructions that, when executed
causes the computer to open or start a specific computer program or function.
● are the files that tell a computer what actions the computer should perform when running a program.
● Command files- are a set of instructions that perform a set of functions as opposed to running a whole program.
● BATCH FILE- contains a set of operating system commands.
2. DATA FILES
● contain data that have been captured and stored on a computer using a software program. Many times the extension
for the file identifies the software program used to create the file.
● The master index file- contains the unique identifier and related indexes for all entities in the database.
Conceptual model; Includes a diagram and narrative description of the data elements, their attribute, and the relationship
between the data. It defines the structure of the whole database in terms of the attributes of entities (data elements)
relationships, constrain and operation
Structural or physical data records: includes each of the data elements and the relationship between the data elements, as
they will be physically stored on the computer.
FOUR (4) PRIMARY APPROACHES TO THE DEVELOPMENT OF A PHYSICAL DATA MODEL:

1. HIERARCHICAL
● all access data starts at the top of the hierarchy or at the root. A parent node may have several children nodes, but
each child node can only have one parent node.
● Are very effective at representing one-to-many relationships; however they have some disadvantages. Many data
relationships do not fit to one-to-many- model
2. NETWORK MODEL
● developed from hierarchical models. In a network model, the child node is not limited to one parent.
3. RELATIONAL DATABASE MODELS
● consists of a series of files set up as tables, each column represents an attribute, and each row is a record.
Another name for a row is “tuple”.
● joins any two or more files that generate a new file from the records that meet the matching search criteria.
4. OBJECT-ORIENTED MODEL
● This model is developed because the relational model has a limited ability to deal with binary large objects or BLOBs.
● BLOBs-are complex data types such as images, sounds, spreadsheets, or text messages. They are large
monatomic data with parts and subparts that are not easily represented in a relational database.
DATABASE LIFE CYCLE: The development and use of DBMS follow a systematic process called THE LIFE CYCLE OF A
DATABASE SYSTEM.
STEPS IN LIFE CYCLE PROCESS:

1. INITIATION: occurs when a need or problem is identified and the development of a DBMS is seen as a potential
solution.
2. PLANNING AND ANALYSIS
3. DETAILED SYSTEM DESIGN
4. IMPLEMENTATION
5. EVALUATION AND MAINTENANCE
COMMON DATABASE OPERATIONS

3 BASIC TYPES OF DATA PROCESSING OPERATIONS:
1. Data Input Operations: are used to enter new data, update data in the system or change data in the DBMS.
2. Data Processing Processes: are DBMS- directed actions that the computer performs on the data once entered into
the system.
3. Data Output Operations: includes online and written reports.
DATA WAREHOUSE a large collection of data imported from several different systems within one database. The source of
the data includes not only internal data from the institution but can also include data from external sources.
Functions of a data warehouse

● The data warehouse must be able to extract data from the various computer systems and import that data into the
data warehouse.
● The data warehouse must function as a database able to store and process all of the data in the database.
● The data warehouse must be able to deliver the data in the warehouse back to the users in the form of information
KNOWLEDGE DISCOVERY SYSTEM OR DATA TO KNOWLEDGE APPLICATION
● -Process of extracting information and knowledge from large scale databases.
● -uses powerful automated approaches for the extraction of hidden predictive information from large databases
3 types of data mining processes:

1. PREDICTING – discovering variables that predict or classify a future event. Ex: decision tree, neural networks
2. DISCOVERY – discovering patterns, associations, or clusters within a large dataset. Ex: apriori; fractionalization
3. DEVIATIONS – discover the norm via pattern recognition and then discover deviations from this norm Ex: scatter
plots, parallel coordinates
CRISP-DM MODEL: -is an international cross industry model it is now being applied to data mining within healthcare.
6 PHASES OF DATA MINING PROCESSES DESCRIBED BY CRISP-DM MODEL:

1. Understanding the business
2. Understanding the data
3. Data preparation
4. Modeling
5. Evaluation
6. Deployment
SPREADSHEETS
● Spreadsheet is an arrangement of cells in columns and rows used to organize, analyze, calculate and report
information, usually in numerical form.
● The first electronic spreadsheet was named VISICALC, short for visual calculator, and was created in 1979 of the
Apple and the acceptance of a personal computer as a tool for business.
● Microsoft Excel is currently the industry standard for spreadsheets and worksheets. It is the most used spreadsheet
and is available for Windows, MacOS,Android and iOS. Other programs used include Google sheets, a cloud web-
based program, LibreOffice, and several more.
● Microsoft Excel is a spreadsheet developed by Microsoft for Windows, Mac OS X, Android and iOS.
1. Calculation
2. Graphing tools
3. Pivot tables
4. A macro programming language called Visual Basic for Applications
● Components of a spreadsheet
1. Cell – a box where all data is inputted within a spreadsheet
2. Row – cells aligned horizontally. Rows are numbered 1,2,3….
3. Column – cells aligned vertically, Columns are labeled A, B, C….
4. Range – the specification for a series of cells
5. A colon (:) – separates the start and end cell references
e.g. A1:A9 –part of a column; A1:A9 – part of a row
6. Function – an operation applied to a range of cells, always beginning with an equal “=” sign e.g. =SYM
(A1:A5)
7. Formula – an algebraic expression, must begin with an equal sign. Can contain any combination of
numbers; operators(+ - * /); cell references, ranges, functions
● Application of spreadsheet
− To manage name list of data records
− To perform mathematical calculation easily in daily
business − Inventory management
− Create forms and consolidate results
− Analytical tools
− Corporate budgeting
● Many medical professionals, from doctors’ offices to researchers, use Excel to manage their data
● Excel is a powerful tool for keeping track of patient appointments, Scheduling doctors, and organizing other
information, such as contact numbers or insurance data. Many clinics, hospitals and practitioners use Excel for
these functions
● Excel can also be used to keep track of medications, prescriptions and other health information
STATISTICAL PACKAGE FOR SOCIAL SCIENCES (SPSS)
● SPSS is used by various kinds of researchers for complex statistical data analysis
● Used by market researchers, health researchers, survey companies, government entities, education researchers,
marketing organizations, data miners, and many more for the processing and analyzing of survey data.
● SPSS can open all file formats that are commonly used for structured data such as:
− Spreadsheets from MS Excel or Open Office
− Plain text files (.txt or .csv)
− Relational (SQL) databases
− Stata and SAS
● The core functions of SPSS (offers four programs that assist researchers with their complex data analysis needs)
1. Statistical Program – provides a plethora of basic statistical functions, some of which include frequencies, cross
tabulation and bivariate statistics.
2. Modeler program – enables researchers to build and validate predictive models using advanced statistical
procedures.
3. Text analytics for survey program- helps survey administrators uncover powerful insights from responses to open
ended questions
4. Visualization designer- allows researchers to use their data to create a wide variety of visuals like density charts and
radial boxplots with ease.
● SPSS main features
− Opening data files, either in SPSS own file format or many others
− Editing data such as computing sums and means over columns or rows of data. SPSS has outstanding options for
more complex operations as well
− Creating tables and charts containing
frequency counts or summary of statistics
over (groups of) cases and variables
− Running inferential statistics such as
ANOVA, regression and factor analysis
− Saving data and output in a wide variety of file
formats.
SAS PROGRAM COMPONENTS
● Previously Statistical Analysis System

● Data steps typically create or modify SAS
data sets, but they can also be used to
produce custom-designed reports.
For example, you can use DATA steps to:
− Put your data into a SAS data set
− Compute the values for new variables
− Check for and correct errors in your data
− Produce new SAS data sets by sub-setting,
merging, and updating existing data sets
● PROC (procedure) steps typically analyze

and process data in the form of a SAS data
set, and they sometimes create SAS data
sets that contain the results of the procedure.
PROC steps control a library of prewritten
routines that perform tasks on SAS data
steps, such as listing, sorting,
and summarizing data. For example, you
can use PROC steps to:
− Print report
− Produce descriptive statistics
− Create a tabular report
− Produce plots and charts
● Writing report with SAS

− With SAS procedures, SAS DATA steps, and SAS features such as the Output Delivery System(ODS) and the macro
facility, you have the tools to succeed at the writing program that analyze your data and create reports.
− The examples show that the SAS program solves many common report writing tasks. The examples range from simply
listing the observation in a data set to computing summary statistics to creating customized reports with SAS DATA
step statements tailoring report output by including ODS features.
IN VIVO
● Are those in which the effects of various biological entities are tested on whole, living organisms or cells, usually
animals, including humans, and plants, as opposed to a tissue extract or dead organism.
● Importance of in Vivo: performing in Vivo studies is crucial to the development of medical devices, surgical
instruments, procedures and/or novel therapies. InVivo studies also provide data that is important for proof-of-
concept determination, function validation, peer review manuscript preparation, FDA applications and clinical trials.
● Usage of in Vivo: When a study is performed in vivo, it can include things like performing experiments in animal
models, or in a clinical trial in case of humans. In this case, the work is taking place inside a living organism.
− For example : an experiment that is done in vivo is done in the body of a living organism as opposed to in
a laboratory method that does not use the living organism as the host of the test.

1. Which of the following are approaches in organizing data?

A. Sorting C. Calculating
B. Summarizing D. All of the above
ANSWER: D
RATIO: Some common approaches in organizing data are sorting, classifying, summarizing, and calculating.
2. Refers to an organized collection of structured information, or data, typically stored electronically in a computer
system.
A. Information system C. Database
B. System D. None of the above
ANSWER: C
RATIO: Database is an organized collection of related data. This is a collection of information that is organized so that it
can easily be accessed, managed, and updated. A common paper example is a phonebook. A much more complex example
can be a patient’s medical record.
3. What is the most complex and effective information system?

A. Database C. Human brain
B. Computer D. Computer system
ANSWER: C
RATIO: The brain is the most complex organ in the human body. It produces our every thought, action, memory, feeling
and experience of the world. This jelly-like mass of tissue, weighing in at around 1.4 kilograms, contains a staggering one
hundred billion nerve cells, or neurons.
4. Refers to computer programs used to input, store, modify, process and access data in a database.
A. in vivo C. SAS
B. SSPS D. DBMS
ANSWER: D
RATIO: Database Management Systems are computer programs used to input, store, modify, process and access data in
a database. Before the DBMS can be used, the DBM software must first be configured to manage the data specific to the
project. This process of configuring the database software is called database system design.
5. Executable files consist of a computer program or set of instructions that, when executed, causes the computer to
open or start a specific computer program or function.
A. Processing Files C. Database Files
B. Data Files D. Project Files
ANSWER: A
RATIO: Processing files are executable files consist of a computer program or set of instructions that, when executed
causes the computer to open or start a specific computer program or function. These are the files that tell a computer what
actions the computer should perform when running a program.
6. It contains data that have been captured and stored on a computer using a software program:
A. Processing Files C. Database Files
B. Data Files D. Project Files
ANSWER: B
RATIO: Data files contain data that have been captured and stored on a computer using a software program. Many times
the extension for the file identifies the software program used to create the file. The master index file- contains the unique
identifier and related indexes for all entities in the database.
7. What is the first step in the database life cycle?
A. Implementation C. Initiation
B. Maintenance D. Analysis
ANSWER: C
RATIO: Initiation is the firsts step in life cycle process. Initiation occurs when a need or problem is identified, and the
development of a DBMS is seen as a potential solution.
8. Which of the following is not part of data mining processes?

A. Publishing C. Discovery
B. Predicting D. Deviation-discovery
ANSWER: A
RATIO: Three types of data mining processes are predicting, discovery, and deviations. Predicting includes discovering
variables that predict or classify a future event. Discovery on the other hand includes discovering patterns, associations, or
clusters within a large dataset. Deviations also discover the norm via pattern recognition and then discover deviations from
this norm.
9. Refers to an arrangement of cells in columns and rows used to organize, analyze, calculate and report information,
usually in numerical form.
A. Folder C. Spreadsheets
B. Excel D. Word
ANSWER: C
RATIO: Spreadsheet is an arrangement of cells in columns and rows used to organize, analyze, calculate and report
information, usually in numerical form. The first electronic spreadsheet was named VISICALC, short for visual calculator,
and was created in 1979 of the Apple and the acceptance of a personal computer as a tool for business.
10. Are those in which the effects of various biological entities are tested on whole, living organisms or cells, usually animals,
including humans, and plants, as opposed to a tissue extract or dead organism.
A. In Vivo C. SPSS
B. SAS D. DBPS
ANSWER: A
RATIO: In vivo are those in which the effects of various biological entities are tested on whole, living organisms or cells,
usually animals, including humans, and plants, as opposed to a tissue extract or dead organism. Importance of in Vivo:
performing in Vivo studies is crucial to the development of medical devices, surgical instruments, procedures and/or novel
therapies. In Vivo studies also provide data that is important for proof-of-concept determination, function validation, peer
review manuscript preparation, FDA applications and clinical trials.
LESSON WRAP-UP
AL Activity: CAT: MUDDIEST POINT
This technique will help you determine which key points were missed in the main lesson. You will respond to only one
question:
In today’s session, what was least clear to you?
In today’s session, the least clear to me was the components of a spreadsheet.
Nursing Informatics
Session 22
LESSON TITLE: ENHANCING INFORMATICS SKILL Materials:

Pen and notebook
LEARNING OUTCOMES:
References:
At the end of the lesson, you can: Calano, Roel B. & Del Rio, Fernando. (2017).
1. Understand the use of spreadsheets and Excel; Health informatics: An illustrative approach (1st
2. Identify MS Excel window components; ed.)
3. Learn MS Excel basic functions;
4. Scroll through a worksheet and navigate between Saba, Virginia & McCormick, Kathleen. (2006).
worksheets; and, Essential of nursing informatics (4th ed.).
5. Create and save a workbook file. McGraw-Hill Companies Inc.
Answer this question: How would you describe the significance of data processing in a clinical setting?
Data processing in healthcare allows health systems to create holistic views of patients, personalize treatments,
advance treatment methods, improve communication between doctors and patients, and enhance health outcomes.
MAIN LESSON
Spreadsheet
● Electronic sheet of paper organized by columns & rows
● Advantage of an electronic spreadsheet is it allows you to easily change data and have all “related”
calculations automatically update.
Advantages of Electronic Spreadsheet
● The calculated results are accurate and reliable.
● All kinds of complicated calculations can be performed very easily.
● The worksheet can be quite big in size and any part of it can be viewed or edited.
● It provides a graphics facility.
● The entire worksheet or any part of it can be printed in the desired format.
● The worksheet can be saved in an electronic file and can be modified later.
● An existing worksheet or any part of it can be merged with a new worksheet.
● Electronic spreadsheet programs have several mathematical, financial and statistical functions which are built-in
and are very user-friendly.
MS EXCEL
● is the most widely used spreadsheet program and is part of Microsoft Office suite. It can handle various types of
data and is very good for the purpose of calculations. Excel has been rightly called a word processor for numbers.
● is a spreadsheet program that is used to record and analyse numerical data
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An excel document is referred to as a workbook. A workbook holds one or more worksheets (Spreadsheets). In other words,
a workbook is a collection of worksheets stored in a single file. A workbook is useful for grouping the worksheets of a project
together.
A worksheet is a table-like document containing rows and columns that holds data and formulas.
● is a collection of rows and columns? When a row and a column meet, they form a cell. Cells are used to record
data.
● There are 16,384 columns and 10,48,576 rows in each worksheet.
● The columns are named A, B, C.....up to Z, then AA, AB, AC.....up to ZZ, and then AAA, AAB, AAC....up to XFD.
● Rows are numbered from 1 to 10,48,576.
● A box (column-row intersection) in a worksheet is called a cell.
● There are 17,179,869,184 cells in each worksheet.
● Each cell has a cell address or cell reference. A cell address is formed by column letter and row number. Ex: B12
is the cell address for the cell located in column B and row 12
Microsoft Excel Basic Functions

1. SUM: It returns the sum of numeric values in a cell. You can refer to the cells where you have values or simply
insert the values into the function
2. COUNT: It returns the count of numeric values in a cell. You can refer to the cells where you have values or simply
insert the values into the function
3. AVERAGE: It returns the average of numeric values in a cell. You can refer to the cells where you have values or
simply insert the values into the function
4. TIME: It returns a valid time serial number as per Excel's time format. You need to specify hours, minutes and
seconds
5. DATE: It returns a valid date serial number as per Excel's time format. You need to specify day, month and year
6. LEFT: This function extracts specific characters from a cell/string starting from the left (start). You need to specify
the text and number of characters to extract
7. RIGHT: This function extracts specific characters from a cell/string starting from the right (last). You need to specify
the text and number of characters to extract
8. VLOOKUP: It looks up for a value in a column and can return that value or a value from the correspondent columns
using same row number
9. IF: This function returns a value when the specific condition is TRUE and returns another values it condition is
FALSE
10. NOW: It returns the current date and time in the cell where you insert it using your system's settings
Microsoft Excel Window Components

✔ The Ribbon is designed to help you quickly find the commands that you need to complete a task. Commands are
organized in logical groups, which are collected together under Tabs. Each Tab relates to a type of activity, such as
formatting or laying out a page. To reduce clutter, some Tabs are shown only when needed. For example, the
Picture Tools tab is shown only when a picture is selected.
✔ File Menu: Here you will find the basic commands such as open, save, print, etc.
✔ Quick Access Toolbar: The place to keep the items that you not only need to access quickly, but want to be
immediately available regardless of which of the Ribbon's tabs you're working on. If you put so many items on the
Quick Access Toolbar that it becomes too big to fit on the title bar, you can move it onto its own line.
✔ Tell Me: This is a text field where you can enter words and phrases about what you want to do next and quickly get
to features you want to use or actions you want to perform. You can also use Tell Me to find help about what you're
looking for, or to use Smart Lookup to research or define the term you entered.
✔ Formula Bar: A place where you can enter or view formulas or text.
✔ Expand Formula Bar Button: This button allows you to expand the formula bar. This is helpful when you have either
a long formula or large piece of text in a cell.
✔ Worksheet Navigation Tabs: By default, every workbook starts with 1 sheet.
✔ Insert Worksheet Button: Click the Insert New Worksheet button to insert a new worksheet in your workbook.
✔ Horizontal/Vertical Scroll: Allows you to scroll vertically/horizontally in the worksheet.
✔ Normal View: This is the “normal view” for working on a spreadsheet in Excel.
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✔ Page Layout View: View the document as it will appear on the printed page.
✔ Page Break Preview: View a preview of where pages will break when the document is printed. ✔ Zoom Level:
Allows you to quickly zoom in or zoom out of the worksheet.
Navigating in the Excel Environment
Below is a table that will assist you with navigating/moving around in the Excel environment.
Key Description
ARROW Move one cell up, down, left, or right in a worksheet. SHIFT+ARROW KEY extends
KEYS the selection of cells by one cell.
Deletes one character to the left in the Formula Bar. Also clears the
BACKSPACE content of the active cell.
In cell editing mode, it deletes the character to the left of the insertion point.
Removes the cell contents (data and formulas) from selected cells without
DELETE affecting cell formats or comments.
In cell editing mode, it deletes the character to the right of the insertion point.
Moves to the cell in the lower-right corner of the window when SCROLL LOCK is
turned on.
Also selects the last command on the menu when a menu or submenu is visible.
CTRL+END moves to the last cell on a worksheet, in the lowest used row of the
END rightmost used column. If the cursor is in the formula bar, CTRL+END moves the
cursor to the end of the text. CTRL+SHIFT+END extends the selection of cells to the
last used cell on the worksheet (lower-right corner). If the cursor is in the formula bar,
CTRL+SHIFT+END selects all text in the formula bar from the cursor position to the
end—this does not affect the height of the formula bar.
Completes a cell entry from the cell or the Formula Bar, and selects the cell
ENTER
below (by default).
Cancels an entry in the cell or Formula Bar. Closes an open menu or
ESC
submenu, dialog box, or message window.
Moves to the beginning of a row in a worksheet. CTRL+HOME moves to the
HOME
beginning of a worksheet.
PAGE DOWN Moves one screen down in a worksheet.
PAGE UP Moves one screen up in a worksheet.
In a dialog box, performs the action for the selected button, or selects or clears a
check box.
SPACEBAR CTRL+SPACEBAR selects an entire column in a worksheet.
SHIFT+SPACEBAR selects an entire row in a worksheet.
CTRL+SHIFT+SPACEBAR selects the entire worksheet.
TAB Moves one cell to the right in a worksheet.
To Select a Column: Click on the column letter
To Select a Row: Click on the row number
To Select the Entire Worksheet: Click above row 1 and to the left of column A or hit CTRL A on the keyboard
Entering Text
Any items that are not to be used in calculations are considered, in Excel’s terminology, labels. This includes numerical
information, such as phone numbers and zip codes. Labels usually include the title, column and row headings.
To Enter Text/Labels:
1. Click in a cell
2. Type text
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3. Press Enter
NOTE: By default, pressing the Enter key will move you to the cell below the active cell.
The label actually “lives” in the cell you typed it into. If you type long text it might appear to be in multiple columns. It is
important to understand this concept when trying to apply formatting to a cell. Using the formula bar will confirm
where the label actually “lives.”
Autofill
Frequently, it is necessary to enter lists of information. For example, column headings are often the months of the year or
the days of the week. To simplify entering repetitive or sequential lists of information, Excel has a tool called Autofill. This
tool allows preprogrammed lists, as well as custom lists, to be easily added to a spreadsheet.
Entering Values
Numerical pieces of information that will be used for calculations are called values. They are entered the same way as
labels. It is important NOT to type values with characters such as “,” or “$”.
To Enter Values:
1. Navigate to a cell
2. Type a value
3. Press Enter
Creating Formulas
Formulas perform calculations or other actions on the data in your worksheet. A formula starts with an equal sign (=). It is
possible to create formulas in Excel using the actual values, such as “4000*.4” but it is more beneficial to refer to the cell
address in the formula, for example “D1*.4”.
One of the benefits of using a spreadsheet program is the ability to create a formula in one cell and copy it to other cells.
Most spreadsheet formulas use a concept called relative referencing.
This is the explanation of relative referencing from Excel’s help file:

“A relative cell reference in a formula, such as A1, is based on the relative position of the cell that contains the formula
and the cell the reference refers to. If the position of the cell that contains the formula changes, the reference is changed.
If you copy the formula across rows or down columns, the reference automatically adjusts. By default, new formulas use
relative references. For example, if you copy a relative reference in cell B2 to cell B3, it automatically adjusts.” It is also
important to know the operators Excel uses for formulas:
Operator (Key) Function
= Begins all Excel functions and formulas
+ Addition
- Subtraction
* Multiplication
/ Division
To Create a Formula:
1. Click in a 3. Type the
cell 2. Press the = formula
key 4. Press Enter
Copying Formulas
Like many things in Excel, there is more than one way to copy formulas. Feel free to choose what works best for you.
To Copy Formulas Using Autofill:

1. Click in the cell that contains the formula
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2. Position the mouse on the Autofill handle (a thin black cross will appear)
3. Click and drag to copy the for
To Copy Formulas Using Copy and Paste:

1. Click in the cell that contains a formula
2. Select Copy on the Home Ribbon in the Editing group
3. Highlight the cell where you would like to paste the formula
4. Select Paste on the Home Ribbon in the Editing group
Autosum Function
The most common formula in Excel is SUM, or the addition of multiple values. In this example, we could create a formula
that reads =C6+D6+E6+F6+G6+H6. That’s a lot of typing! Instead, we can use the SUM function and specify a range of
cells.
Functions are more complex formulas that are invoked by typing their name. In this example, we will use the SUM function.
Excel has over 200 functions that can be used. Because SUM is the most common function, it is the only one with its own
toolbar button.
When working with functions, the cells used in the formula are referred to as the range. A range is a group of cells that are
specified by naming the first cell in the group and the last cell. For example, A1:D1 is a range that includes cells A1, B1, C1
and D1.
To Create the Total Column’s Values Using Autosum:

1. Click in the cell where you would like the Total to be located
2. Press the Autosum button on the Home Ribbon
The Autosum function automatically looks for cells that have values in them. It will read values until it finds the first blank
cell. Autosum will always look for values in the cells above it first, then to the left. This means that you need to be aware of
what cells will be in the formula. Autosum will select the range of cells to use in the formula by highlighting the range.
Saving a Worksheet
When working in Excel it is necessary to save your files. It is also very important that while working, your file is saved
frequently. When naming a file, you are restricted to 255 characters. Avoid most punctuation; spaces are acceptable.
To Save the File:
1. Click on the File tab 3. Choose the

2. Click Save destination
4. Type a file name
5. Click Save
Editing Cells
Excel provides a major enhancement over earlier spreadsheet products in its ability to edit cells easily. There are various
methods for cell editing, including double-clicking in the cell, using the F2 key, and typing in the formula bar.
To Edit a Cell in the Worksheet:

1. Position yourself in the cell you would like to edit
2. Press the F2 key on the keyboard or double-click in the cell
3. Use the backspace or delete keys to edit the cell
4. Press Enter when you have finished editing the cell
~OR~
1. Click in the cell you would like to edit

2. Click in the formula bar and make any necessary changes
3. Press Enter when you have finished editing the cell
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Undo
Excel and other Windows applications have a convenient method of correcting mistakes known as Undo. In many
applications, including Excel, you can undo an almost limitless number of commands. The Undo button has a small down-
pointing arrow next to it. When pressed, it will display a list of actions that can be undone. Redo works in the same way,
allowing you to repeat actions.
Excel will undo actions in reverse chronological order, meaning that the most recent command is reversed first, then the
one prior to that, and so on. You cannot reverse an earlier action using Undo without first undoing the actions that were
performed after it.
NOTE: The list of commands to undo is reset after the file is saved. You cannot use Undo to fix an error after the file is
saved.
To Undo a Command:
Click Undo
Clearing Cells
As we begin to look at formatting, it is important to understand what makes up the contents of a cell. There are three distinct
items that can be in a cell:
✔ Contents
✔ Formats
✔ Comments
These allow items to be formatted properly, even if the values change. However, when trying to delete or clear a cell, it can
be a bit tricky. Excel stores formats and contents separately, simply deleting the contents does not delete the format.
To Clear a Cell Format:

1. Click in the cell that contains formatting
2. Click the drop-down arrow next to the Clear button on the Home tab in the Editing group
3. Click Clear Formats Formatting Values
Applying formats to any cell(s) can be done either using the Font, Alignment and Number groups or using the dialog box
which will include all the formatting options.
To Apply the Currency Format:

1. Highlight the cell(s)
2. Click on the Currency Style button on the Home tab in the Number group
3. If necessary, click on the Increase or Decrease Decimal button on the Number group
To Apply the Comma Format:

1. Highlight cells
2. Click on the Comma Style button on the Number group
3. If necessary, click on the Increase or Decrease Decimal button on the Number group
Formatting Labels
A Label, or text formatting is applied virtually the same way it is done in word processing programs.
To Format the Title Labels:

1. Highlight the cell(s)
2. Select a font from the Font group
3. Select a point size from the Font group
Using the Dialog Box:

1. Highlight the cells
2. Click on the arrow in the corner of one of the formatting groups (Font, Alignment, Number) to open the Format
Cells dialog box and click on one of the tabs
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Format Painter
Frequently, you will need to take a format that is applied to one cell and apply it to other cells. A quick way to do this is by
using the Format Painter.
To Apply a Format to Cells:

1. Highlight cell(s)
2. Format the cell(s) to the desired format
3. Select the formatted cell(s)
4. Click the Format Painter from the Clipboard group of the Home tab
5. Highlight the cells you wish to format
Tips and Tricks: If you would like the Format Painter to remain active, double-click the Format Painter. It will remain active
until you press the Esc key.
Centering Text Across Columns
When it comes to titles, it may be preferable to have the information centered across the document, rather than in only one
cell. Excel uses the feature Merge Cells to accomplish this.
To Center the Title Across Columns:

1. Highlight cell(s)
2. Click the Merge and Center button on the Alignment group
NOTE: Each cell must be done individually. Excel will delete the contents of all but the top most cell if multiple cells are
selected.
This option basically takes all the cells in the highlighted range and merges them into one large cell. For example, the range
A1:F1 became cell A1 after the Merge Cells button was selected. There is no cell B1, C1, etc. any longer. Creating a Basic
Chart
1. Highlight the data to be charted 3. Click on a Chart Type in the Charts
2. Click on the Insert tab group
4. Click on a Chart Style
To Move your Chart:
Click and drag the chart to a new location on the worksheet.
When the chart is selected you will notice a new tab “Chart Tools” on the Ribbon. If you do not see the Chart Tools, click on
the chart to select it. Under Chart Tools you will find 2 tabs:
✔ Design
✔ Format
Excel Functions
As we have previously seen, the power of Excel lies in its ability to perform calculations. The real strength of this is shown
in Functions. Functions are more complex formulas that are executed by using the name of a function and stating
whatever parameters the function requires.
Function Defined
=SUM(range of cells) returns the sum of the selected cells
=AVERAGE(range of cells) returns the average of the selected cells
=MAX(range of cells) returns the highest value of the selected cells
=MIN(range of cells) returns the lowest value of the selected cells
=COUNT(range of cells) returns the number of values of the selected
cells
To Enter the SUM Function:
1. Click in a cell
2. Click on the AutoSum button in the Editing group
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3. Highlight the range of cells that are to be added (The colon means “through”)
4. Press ENTER
To Insert the Average Function into the Worksheet:

1. Click in a cell
2. Click on the drop-down arrow next to the AutoSum button
3. Click on Average
4. Highlight the range of cells be calculated
5. Press ENTER
To Insert the MAX Function into the Worksheet:

1. Click in a cell
3. Click on Max
5. Press ENTER
To Insert the MIN Function into the Worksheet:

1. Click in a cell
3. Click on Min
5. Press ENTER
To Insert the COUNT NUMBERS Function into the Worksheet:

1. Click in a cell
3. Click on Count Numbers
5. Press ENTER
Printing a Worksheet To Print, Preview and Modify Page Setup

1. Click on the File tab
2. Click on Print
The spreadsheet shows as it will be printed. You can proceed to print the document from here, or you can change things
to make the printed output look different.
Page Setup
You can change options under Settings or you can click on Page Setup.
Clicking on Page Setup will open a dialog box with four tabs:
✔ Page ✔ Header/Footer
✔ Margins✔ Sheet
Page:
1. Change the Orientation
2. Adjust the Scaling
3. Change the Paper Size
Margins:
1. Change the margins
2. Center on the page either horizontally, vertically or select both
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Header/Footer:
1. To select from one of the already created headers/footers, click on the drop-down arrow for Header and also for
Footer and choose from the list
2. To create a custom header and/or footer, click on Custom Header and Custom Footer
This area is made of three sections – left, center and right. Any information added in these sections will appear in
that area (left, center or right) in the header or footer. You will also see a row of buttons in this dialog box.
Following are their functions:
BUTTON FUNCTION
IMAGE
Format Text
Page Number
Total Number of Pages
Date
Time
File Path
Filename
Sheet Name
Picture
Format Picture
3. Click in a section to position your cursor
4. Enter text/fields
5. Click OK when finished
Sheet Tab:
1. Repeat Rows and Columns under Print Titles
2. Check off what to print under Print
3. Change the Page Order
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1. Refers to an electronic sheet of paper organized by columns and rows

a. Spreadsheet c. Worksheet
b. Workbook d. Window
ANSWER: A
RATIO: Spreadsheet is an electronic sheet of paper organized by columns & rows. Advantage of an electronic spreadsheet
is it allows you to easily change data and have all “related” calculations automatically update.
2. To copy cell contents, you can select the cell and then press the _____ keys.
a. CTRL+V c. CTRL+B
b. CTRL+X d. CTRL+C
ANSWER: D
RATIO: Control+C is a common computer command. It is generated by pressing the C key while holding down the Ctrl key
on most computer keyboards. In graphical user interface environments that use the control key to control the active program,
control+C is often used to copy highlighted text to the clipboard.
3. It is the most widely used spreadsheet program and is part of Microsoft Office suite.
a. MS Word c. MS Excel
b. MS PowerPoint d. None of the above
ANSWER: C
RATIO: MS Excel is the most widely used spreadsheet program and is part of Microsoft Office suite. It can handle various
types of data and is very good for the purpose of calculations. Excel has been rightly called a word processor for numbers.
It is a spreadsheet program that is used to record and analyse numerical data.
4. It is a table-like document containing rows and columns that holds data and formula.
a. Row c. Spreadsheet
b. Columns d. Worksheet
ANSWER: D
RATIO: A worksheet is a table-like document containing rows and columns that holds data and formulas. It is a collection
of rows and columns? When a row and a column meet, they form a cell. Cells are used to record data. ● There are 16,384
columns and 10,48,576 rows in each worksheet. The columns are named A, B, C.....up to Z, then AA, AB, AC.....up to ZZ,
and then AAA, AAB, AAC....up to XFD. Rows are numbered from 1 to 10,48,576. A box (column-row intersection) in a
worksheet is called a cell. There are 17,179,869,184 cells in each worksheet. Each cell has a cell address or cell reference.
A cell address is formed by column letter and row number. Ex: B12 is the cell address for the cell located in column B and
row 12.
5. To paste copied cell contents, you can press the _____ keys.
a. CTRL+C c. CTRL+V
b. CTRL+P d. CTRL+X
ANSWER: C
RATIO: In a Windows PC, holding down the Ctrl key and pressing the V key pastes the contents of the clipboard into the
current cursor location.
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6. Deletes one character to the left in the Formula Bar. Also clears the content of the active cell.
a. Delete c. End
b. Backspace d. Arrow keys
ANSWER: B
RATIO: Backspace deletes one character to the left in the Formula Bar. Also clears the content of the active cell. In cell
editing mode, it deletes the character to the left of the insertion point.
7. Completes a cell entry from the cell or the Formula Bar,and selects the cell below (by default).
a. Enter c. Alt
b. Escape d. Home
ANSWER: A
RATIO: Alternatively known as a Return key, with a keyboard, the Enter key sends the cursor to the beginning of the next
line or executes a command or operation. Most full-sized PC keyboards have two Enter keys; one above the right Shift key
and another on the bottom right of the numeric keypad.
8. Refers to the numerical pieces of information that will be used for calculations.
a. Numbers c. Letters
b. Values d. Formula
ANSWER: B
RATIO: Numerical pieces of information that will be used for calculations are called values. They are entered the same way
as labels. It is important NOT to type values with characters such as “,” or “$”.
9. The place to keep the items that you not only need to access quickly, but want to be immediately available regardless
of which of the Ribbon's tabs you're working on.
a. Tell me c. Page layout
b. Formula bar d. Quick access toolbar
ANSWER: D
RATIO: Quick access toolbar is the place to keep the items that you not only need to access quickly, but want to be
immediately available regardless of which of the Ribbon's tabs you're working on. If you put so many items on the Quick
Access Toolbar that it becomes too big to fit on the title bar, you can move it onto its own line.
10. Cancels an entry in the cell or Formula Bar. Closes an open menu or submenu, dialog box, or message window
a. Esc c. Enter
b. Home d. Page down
ANSWER: A
RATIO: On computer keyboards, the Esc key Esc (named Escape key in the international standard series ISO/IEC 9995)
is a key used to generate the escape character (which can be represented as ASCII code 27 in decimal, Unicode U+001B,
or Ctrl + [ ).
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LESSON WRAP-UP
AL Activity: K-W-L
The letters KWL form an acronym for "Know, What, Learn." This is a strategy is an instructional technique used to improve
reading comprehension.
Fill up the following grids:

K – what you think you already know about this particular topic
W – you are encouraged to think about the gaps in your knowledge by filling out what you want to know
L – once the topic is completed, return to your grids to fill in the final ‘L’ column. Here, you confirm the accuracy of the first
two columns and compare what you have learned with your initial thoughts on the topic in the ‘K’ column.
K WHAT I KNOW
• Understand the use of spreadsheets and Excel
• Identify MS Excel window components;
W WHAT I WANT TO KNOW

• Learn MS Excel basic functions
L WHAT I LEARNED
• Understand the use of spreadsheets and Excel

• Identify MS Excel window components
12
Nursing Informatics
Session 23
LESSON TITLE: Materials:

▪ FOCUS ON CLINICAL & HIS Pen and notebook
▪ NURSE INFORMATICIST & THE NURSE
ENTREPRENEUR
LEARNING OUTCOMES:

1. Explain the Importance of clinical and hospital
information system;
2. State the benefits of Computer–based patient health
records;
3. Explain on how to handle computer threats and
viruses;
4. Describe Information Process Flow with Clinical and
Hospital Information System; References:
5. Determine the goal and metastructure of nursing Calano, Roel B. & Del Rio, Fernando. (2017).
informatics; Health informatics: An illustrative approach (1st
6. Differentiate nurse informatics from nurse ed.)
entrepreneur;
7. Describe the role of a nurse informatics and the nurse Saba, Virginia & McCormick, Kathleen. (2006).
entrepreneur; and, Essential of nursing informatics (4th ed.).
8. Identify the levels of informatics competencies of a McGraw-Hill Companies Inc.
nurse.
Answer the question: What do you think are the benefits of Computer-Based Patient Health Records?
Computer-based patient health care provides accurate, up-to-date, and complete information about patients at the point of care,
enables quick access to patient records for more coordinated, efficient care, secures sharing electronic information with patients
and other clinicians, help providers more effectively diagnose patients, reduce medical errors, and provide safer care, improves
patient and provider interaction and communication, as well as health care convenience. enables safer, more reliable prescribing,
helps promote legible, complete documentation and accurate, streamlined coding and billing, enhances privacy and security of
patient data, helps providers improve productivity and work-life balance, enable providers to improve efficiency and meet
their business goals, lastly, it reduces costs through decreased paperwork, improved safety, reduced duplication of testing, and
improved health.
MAIN LESSON
CLINICAL AND HOSPITAL INFORMATION SYSTEM
Paper-Based Patient Health Records
● Paper-based patient health records are essentially needed by the nurses and healthcare provider to record their
observations and plans so that they could be reminded of the applicable details.
● This is a cyclic problem because of the unavailability of common data and information.
● The paper-based record system that has been with the health industry a century ago has struggled to adjust to
accommodate to new requirements as the healthcare system and medicine have changed significantly.
Inadequacy of the Traditional Paper Record
● The paper-based patient health record is dejectedly insufficient for meeting the objective of the government to establish
the health information system in the Philippines.
● Difficulty in obtaining specific information or translating the data into information in real-time, either about a specific
patient, certain condition or medical scenario or just a general issue that needs immediate attention is a wearisome
but common occurrence in the hospital and clinics.
● Paper-based health patient’s medical records should enhance and implement a more reliable system that provides
simplistic and spontaneous access to the information they need in real time.
● The Electronic Health Records (EHR) system offers optimism for such enhanced access to specific patient information
and should provide a major advantage and mutual benefit for the healthcare quality and the performance of the nurses
and healthcare providers.
● It is still challenging to try to move to a paperless, computer-based clinical record.
● The complexity associated with automating patient health medical records is due to the required training of the users,
the money involved in the planning, purchasing of the necessary computers and software, implementation stage,
educating the patient, migration of the old data (which uses papers) to new set of data through encoding, additional
facilities to put to, storage and data, accessibility of data, introduction to statistical information system, additional
manpower involved, etc.
Benefit of Computer-Based Patient Health Records

● Computerized patient health records can improve health care service by providing nurses and healthcare providers
with better data access, quicker data retrieval, readily translated data into information, more versatile data output and
presentation, less mathematical skills, no need to memorize index, patient profile and tables for references.
● Computer-based patient records can also support decision making for diagnosis and provide guaranteed patient
support.
● Automated patient health records can be integrated into statistical information systems to enhance the results of the
information for evaluation and analysis which can be used to predict results to scenarios and create trending output.
● If the computer-based patient health records are established, it will certainly increase hospital efficiency by reducing
costs, creating parallel works with different conditions and systems, optimizing the schedules of the staff and facilities,
optimizing the capabilities of the nurses and healthcare provider, improved coordination works, minimized irregularities
and errors, eliminate redundancy in workloads, reductions of patients waiting time and creates hierarchy in prioritizing
decisions.
● The first step towards patient record improvement is careful planning and suitable conceptualization of the use of
technologies available.
● Identify the potential barriers and problems or migration to a new system and effective strategy for implementation.
● The data is translated into information which is generated by nurses and healthcare providers through continuous
interaction with the patient or individuals who have personal knowledge of the patient.
● The data and the information will reside in a secured and protected data warehouse to maintain confidentiality and
privacy.
● A derived patient record can be extracted from the repository which can be accessible with the proper approval.
● Derived record contains selected data elements which can be used only for evaluation.
● Through the report generated by the computer-based patient health records system, the management, healthcare
policy makers and other healthcare officials can immediately make action plans.
● A computer-based patient health records system is one of the main components of hospital information systems or
clinical information systems which typically handles both administrative and clinical functions.
● Advances in computer networking and wireless communication technology have now made it possible for clinicians to
access these data from any location whether it is in the office, the hospital, at home or even when traveling out of town.
Implementation of Computer-Based Patient Health Records

● Patient records will provide new dimensions of record functionality through links to other databases, decision support
tools and reliable transmission of detailed information across substantial distances.
● To meet the needs of nurses and other healthcare providers, computer-based health patient records are integrated
into clinical decision support systems coupled with statistical information systems that have customized software
packages.
● Computer-based health patient records can also be integrated to multimedia such as video or computer graphics.
● Every department such as the laboratory, pharmacology and even finance is connected to the communication system.
● Physicians can now be linked to the system in real-time and access the real-time data such as availability of rooms
and services, price of drugs and its availability, patient mapping and patient profiling.
● Computer-based patient records are part of the national care information system.
National Awareness Program

● If this system will be implemented, a proper awareness program is necessary to essentially educate the community
and the entire society.
● Proper instruction on how to use the system, objective of the system, input and output of data, confidentiality and
security of data, information and the system, applicability to the common person.
● Proper acceptance from the community means success of the implementation of the system.
Computer Threats and Viruses

● Security and preservation of the integrity of data should be one of the most important tasks of the computer-based
health patient record system.
● Computer viruses and other potential computer threats that will manifest sabotage and destruction of data can be
properly addressed by computer anti-virus, computer firewalls, data back-up systems and data archiving schemes.
● Data alteration can manifest false data on the system can be addressed by creating a patient profiling scheme,
statistical index and measurable references.
● Computer sabotage can be minimized by implementing proper security both for authorized and unauthorized
personnel.
● One of the principal threats to computer-based systems is the data integrity and the confidentiality of records from
outside sources.
● This can be properly addressed by a substantial data filtering process and protection scheme.
● There are many challenges in effectively implementing clinical information systems including the high cost, the need
to change clinical “workflow”, the need for providers to learn new skills and challenges in capturing clinical data with a
minimum of time and effort on the part of clinicians and representing it in computers for optimal use.
● Concerns about security and confidentiality must also be addressed. ● Clinical informatics research is actively
addressing these concerns.
Clinical Information System

● A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating
and making available clinical information which are important to the healthcare delivery process.
Clinical and Hospital Information System (CIS/HIS)

● Information technology has made a significant impact on the healthcare sector.
● The number of investments in computers and types of hospital systems has increased as well as companies or groups
that offer such systems in the hospital.
● The use of paper medical records is cumbersome, bulky to use and difficult to manage.
● On the other hand, digital records are much easier to handle and improve the workflow efficacy by integrating various
tasks.
● The ultimate objective of the clinical and hospital information system is to build a network of interdependent centers
such as the:
Medical Support System (MSS)
Pharmacy Information System (PIS)
Laboratory Information System (LIS)
Patient Monitoring System (PMS)
Nursing Information System (NIS)
Dietary Information System (DIS)
Operating Room System (ORS)
Facilities Management System (FMS) etc. that are linked with the other system such as the:
Building Management System (BMS)
Information Management System (IMS)
Financial Management System (FMS), etc.
Information Process Flow with Clinical and Hospital Information System
● A Clinical and Hospital Information System (CIS/HIS) can be defined as a computerized system that is designed to
meet all the information needs within a hospital.
● This includes Patient Information processing such as bio-data, allergies and medical alerts, patient accounting system
such as charging, billing, discounts and concessions, claims management, doctor fees, accounts receivable, general
ledger, etc.
● It also includes registration management for booking of appointments, patient registration and queue management,
bed management necessary admissions, allocation of bedroom, transfer and discharge, order management for the
purpose of ordering of medication, diagnostic imaging and treatment, operating theatre scheduling such as surgery,
pharmacy management bagging, labeling and dispensing of ordered medication, material management for item
management, stock take, transfer of items, and job scheduling that performs task management and follow up.
● Other diverse data types such as diagnostic reports related to laboratory, radiology and patient monitoring as well as
providing decision support.
● With this management, the patient waiting time is optimized through effective queue management.
● It only involves one-time registration required per visit and it facilitates the management of doctors’ schedules such
that patients are seen on time.
● It also aids in timely bed-scheduling and most especially medical records are stored electronically and patient history
is maintained.
Advantages of CIS/HIS:
Real-time and easy access to patients’ medical records by healthcare providers
Improved workflow which allows more time for comprehensive patient counseling and review
Reduced errors with the availability of various automation engines - drug interaction engine, medical alert engine,
patient billing engine, etc.
Help healthcare institutions become more community focused and reach out to patients via fax, SMS, etc.
Automated and integrated back-end processes such as pharmacy, billing, purchasing, inventory management,
etc.
Improved clinical outcome analysis - enhanced research productivity through data mining and facilitate institutional
handling of managed care challenges in a timely manner
Improved in hospital inventory management
Better monitoring and management of costs - prescription, consumables, doctors’ fee, etc.
Implementation of a centralized system that allows the sharing of server hardware, system software, interfaces
and operations with other entity such as the Department of Health (DOH)
● With the sharing of information with the central database that is provided by the Department of Health (DOH), the statistical
health officer can perform statistical analysis and investigation online.
Medical Support System
● Directly assist health care providers in interpretation of data and in making clinically related decisions.
Patient Monitoring System
● Provide repeated and continuous observations and/or measurements of a patient's psychological condition through
statistical processes by collecting, storing and processing patient’s data and other input data (physician, pharmacy,
dietary, finance, etc).
● This system allows head officers to interpret and display psychological patient data.
Laboratory Information System
● Supports both processing of data associated with laboratory tests and management functions associated with day to
day operations.
● Laboratory Information Management System (LIMS) tracks samples, integrates instruments and manages various
laboratory functions.
● It also enables prioritizing and viewing of work, generating of reports and ensuring compliance with government
regulations and corporate standards.
● Above all, data integrity is the top priority and stringent measures are taken to ensure the authenticity of the data.
● Other functions of LIS include test ordering system, results reporting, optimal activity scheduling, patient and specimen
identification, data duplicating system, data filing for comparing the results to the other test, data acquisition, remote
interrogation, report generation, quality control, data validation, managerial support and facility management.
Pharmacy Information System
● Collect stores and manage information related to prescription, calculation and management of drugs and the significant
use of drugs to patients.
● The Pharmacy Information System uses the assembly line concept to improve the operational efficiency and accuracy
of the medicine dispensing process.
● The PIS should be capable of the so called picking and packing of medication that will reduce processing time ●
The primary activity of the PIS is to provide medications for patient care in response to a physician’s order.
● When an order is received by the pharmacy, the pharmacies verify it for accuracy and evaluate it against the patient’s
current condition, drug therapy and clinical history.
Functions Supported by Pharmacy Information System

✔ Pharmacy Evaluation ✔ Online Order Entry
✔ Medication Profile Update ✔ Medication
✔ Medical History Profiling System Administration
✔ Facility Management ✔ Inventory Maintenance
✔ Label Printing ✔ Automatic Drug Order
✔ Drug Dispensing Report ✔ Drug Used Report
✔ Controlled Drug Report
Other Related Integrated System ✔ Operating Room System

✔ Dietary Information System ✔ Facilities Management
✔ Emergency Department System
✔ Building Management System
Nursing Informatics
● Nursing informatics is a specialty that integrates nursing science, computer science and information science to
manage and communicate that information and knowledge in nursing practice.
● Nursing informatics facilitates the integration of data, information, and knowledge to support patients, nurses, and
other providers in their decision making in all roles and settings.
● This support is accomplished through the use of information structures, information processes, and information
technology.
● The nursing information is the multidisciplinary scientific endeavor of processing data information, data managing,
analyzing, reporting, making knowledge-based decisions and intermediary for patient care and use this special
knowledge in order to enhance the quality of service and professional practice.
● While more technical than other nursing careers, the main goal of nursing informatics is enhancing patient care.
Better information systems and data mean fewer medical errors and better handling of patient data
Nursing Information System

● Nursing Information Systems (NIS) are computer systems that manage clinical data from a variety of healthcare
environments, and made available in a timely and orderly fashion to aid nurses in improving patient care.
● NIS helps in determining diagnoses, preparing and implementing nursing care plans, and evaluating the care
provided.
● NIS can support nursing management functions such as determining the need for nursing resources, including
scheduling of personnel who have the appropriate level of education, training, or skill to effectively provide care
given specific situations of patient condition.
Conceptual Design of NIS
NURSE INFORMATICIST
Nurse informaticists work as developers of communication and information technologies, educators, researchers, chief
nursing officers, chief information officers, software engineers, implementation consultants, policy developers, and business
owners to advance health care.
Metastructure of NI: The ability of the nurse to utilize data, information, and knowledge to make wise clinical decisions.
NURSE INFORMATICS ROLE

● User liaison- involved in installation of a CIS and interfaces with system vendors, the users and management of
health care institution
● Project manager- planning and implementing informatics project
● Educator- develops and implements educational materials and educational sessions about system to employees
● Product developer-participate in design, production and marketing of new informatics solutions
● Decision support/outcomes manager- use tools to maintain data integrity and reliability
● Systems analyst- serves as link between nursing and information services
● Consultant- provide expert advice, opinions and recommendations based on her area of experience
● Advocate/policy developer- develop the infrastructure of health policy
● Entrepreneur- analyzes nursing information needs and develops market solutions
● Researcher- conduct research to create new informatics knowledge
● Chief information officer provides leadership and management at the executive level for both the organization and
the vendors
● Web Developer-Web development responsibilities
● Programmer-ability to code identified specifications for system development, enhancement or issue resolution ●
Network administrator-ensures networks continuously runs smoothly
HOW NURSE INFORMATICISTS FIT INTO A HEALTHCARE ORGANIZATION
● As a professional who has skills in both nursing and technology, a nurse informaticist can serve as an important
bridge between clinical staff and technical advancement. Since most people in these roles have strong clinical
nursing backgrounds, they can make sure the tools and procedures being implemented will be user-friendly
and practical for the rest of the staff. They’re also able to focus the training of new technology on how it will
improve their ability to care for patients.
● For example, you might prepare training for a team of medical-surgical nurses on the use of a new electronic
medication dispensing system. After the training, you’ll then serve as their point of contact for any questions or
concerns that come up as the system is put in place.
LEVELS OF INFORMATICS COMPETENCIES FOR NURSE

I. THE BEGINNING NURSE First level of informatics competencies for practicing nurses
● should possess basic information management and computer technology skills. Accomplishments should include the
ability to access data, use a computer for communication, use basic desktop software and use decision support
systems
II. THE EXPERIENCED NURSE Second level of informatics competencies for practicing nurses
● should be proficient/ highly skilled in using information management and computer technology to support their major
area of practice.
● being able to make judgments on the basis of trends and patterns within data elements and to collaborate with
nursing informatics nurses to suggest improvements in nursing systems
III. THE INFORMATICS NURSE SPECIALIST Third level of informatics competencies for practicing nurses
● Should have advanced preparation in information management
● should be able to meet the information needs of practicing nurses by integrating and applying information, computer
and nursing sciences
● uses skills in critical thinking, data management and processing, decision making, and system development and
computer skills
IV. THE INNOVATIVE NURSE Fourth level of informatics competencies for practicing nurses
● The informatics innovator will conduct informatics research and generate informatics theory.
● Work lists to remind staff of planned nursing interventions
● Computer generated client documentation including discharge instruction and medication information
● Computer generated nursing care plans and critical pathway
TYPES OF COMPETENCY
1. Computer Literacy: as set of skills that allow individuals to use computer technology to accomplish task
2. Informatics Knowledge: a set of cognitive processes that allows the individual to recognize what, when and where
information is needed and to locate, evaluate and use that information appropriately.
3. Informatics Skills: technical ability to use tools and techniques to improve information and knowledge access,
integration, management and use
SKILLS OF SUCCESSFUL NURSING INFORMATICS SPECIALISTS

● Nursing informatics is different from traditional nursing, and it might require you to have additional skills and
personality traits. Some that can help you succeed include:
● Problem-solving ● Analytical thinking
● Strong interpersonal skills ● Communication skills
● Clinical expertise ● Leadership experience
● Management ability ● Innovative thinking
● Good organization ● Teaching ability
● Knowledge of technology ● Strong information retention
EDUCATION & CERTIFICATION REQUIREMENTS
● You’ll need to be a registered nurse (RN) to start a career in nursing informatics. From there, you might have the
option to learn through on-the-job training, however formal education is increasingly required to work in the field.
Degrees for RNs looking to get into nurse informatics can be earned at the bachelor’s, master’s, or even doctoral
level.
● If you’re currently an RN with an associate’s degree in nursing (AND), you might want to look into earning a
bachelor’s in healthcare administration or informatics. If you already have a Bachelor of Science in Nursing (BSN)
or are looking to advance your career further, you might want to consider earning a master’s in nursing informatics
or even a Doctor of Nursing Practice (DNP) degree.
● No matter which option you choose, having a formal education can help you advance your career. However, as
57% of HIMSS respondents reported having at least a master’s degree, advanced education can help you stand
out to potential employers in this increasingly competitive field.
PROFESSIONAL CERTIFICATIONS
● Among respondents to the HIMSS survey, 79% felt that having a professional certification enhanced their credibility
and marketability, while a whopping 82% felt that having certification had a positive impact on their career. As the
field grows, certification is becoming a greater requirement for many employers.
● Certifications are offered by American Nurses Credentialing Center (ANCC) and the HIMSS. The ANCC Informatics
Nursing Certification (RN-BC) is the most commonly held credential among informatics nurses and is also most
likely to be required by an employer. HIMSS offers 2 certifications: the entry-level Certified Associate in Healthcare
Information and Management Systems (CAHIMS) certification and the advanced-level Certified Professional in
Healthcare Information and Management Systems (CPHIMS).
NURSE INFORMATICIST WORK AREAS
● Hospitals ● Nursing schools

● Clinics ● Healthcare consulting firms
● Long term care facility ● IT companies
FUTURE TRENDS- NI
● Academic networking ● Tele-nursing
● The Virtual University / Virtual reality ● Clinical Governance
● Clinical networking ● Human networking/ Ubiquitous computing
● Electronic patient records ● Robotic Surgery
● Data Scanning
FUTURE-DIRECTIONS
● Prepare nurses with specialized informatics skills
● Enhance practice through informatics projects
● Increase faculty preparation in informatics
● Encourage interdisciplinary collaboration involved in policy making and infrastructure designing, implementation. 1
STRATEGIES TO MINIMIZE THE RISK ●

Never give your computer password.
● Always log off your computer when you leave computer terminal
● Follow your institutional policies and procedure correcting mistakes as computer entries are permanent. ●
Do not leave patient information displayed on the screen ● Keep track of printed information and
display it properly.
NURSE ENTREPRENEURS
Nurse entrepreneurs are nurses who leverage their professional nursing experience to start their own business. The roles
and responsibilities of a nurse entrepreneur are specific to the business they build and can vary from one nurse to the next,
depending on the size of the business and experience of the entrepreneur. On any given day, these tasks may include:
● Caring for patients
● Managing employees and schedules
● Promoting the business, goods, or services to potential clients
● Bookkeeping
● Buying supplies and paying invoices or payroll
● Negotiating contracts
Types of Businesses a nurse can start

Whether opening a storefront, traveling to patients, or working from their dining room table, nurse entrepreneurs work in a
variety of environments, depending on the nature of their business. Examples include:
● Home Healthcare ● Media Publishing
● Consulting ● Med Spa/Cosmetic Nursing
● Private Practice ● Public Advocacy & Education
Roles and Duties of a Nurse Entrepreneur

● Use nursing education and experience to establish their own business venture within the healthcare field
● Promote the business, including advertising and sales efforts to attract and retain customers
● Hire and manage employees to assist in running the business as needed
● Tend to the financial side of running a business, including accounting, payroll and tax issues
● Provide healthcare products or nursing services which may include direct patient care, education or consulting
services depending on the nature of the business
Conclusion
● Healthcare employs the largest number of knowledge workers administrators of healthcare realize that they must tap
into the highly intelligent, skilled and dedicated doctors and nurses resulting in happier employees and improved
safer and efficient patient care NI is governed by standards that have been established by the ANA NI is a diverse
field competencies are developed to ensure that all entry level nurses are ready to enter the technology demands
of the field and to determine the training needs many organizations for nursing informatics and sub organizations
of medical informatics organizations nurses no longer have to enter the field by chance they can obtain an advanced
degree NI grows since its inception and is to continue.

1. Which statement defines the Clinical Information System:
a. Clinical and Hospital Information System covers a wide range of health care services that are provided for
patients who are not admitted overnight to a hospital.
b. Clinical care is a computer based system that is designed for collecting, storing, manipulating and making
available clinical information which are important to the healthcare delivery process.
c. Clinical care applications have integration with medical care environments, food and water supply, disease
treatment, disaster management and control, health environment, health risk factors, economical status,
etc.
d. Clinical care information system provides automated processing of data and information such as allergies
and medical alerts, patient accounting management, doctor fees, etc.
ANSWER: B
RATIO: A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating
and making available clinical information which are important to the healthcare delivery process.
2. Which of these is not a part of the information process flow of the HIS?
a. Collection of Data c. Processing of Data
b. Manipulation of Data d. Analysis of Data
e. Dissemination of Data
ANSWER: B
RATIO: Information process flow with clinical and hospital information system are collection, processing, gathering of data,
analysis, and dissemination.
3. What is stated as one of the advantages of the clinical care information system?
a. Early detection and monitoring of disease and sickness
b. Improvement in hospital inventory management
c. National alertness and preparedness
d. Better monitoring and management of costs - prescription, consumables, doctors’ fees, etc.
e. Real-time and easy access to patients’ medical records by healthcare providers
ANSWER: E
RATIO: Advantages of CIS/HIS are; real-time and easy access to patients’ medical records by healthcare providers,
improved workflow which allows more time for comprehensive patient counseling and review, reduced errors with the
availability of various automation engines - drug interaction engine, medical alert engine, patient billing engine, etc., help
healthcare institutions become more community focused and reach out to patients via fax, SMS, etc., automated and
integrated back-end processes such as pharmacy, billing, purchasing, inventory management, etc, improved clinical
outcome analysis - enhanced research productivity through data mining and facilitate institutional handling of managed care
challenges in a timely manner, improved in hospital inventory management, better monitoring and management of costs -
prescription, consumables, doctors’ fee, etc., implementation of a centralized system that allows the sharing of server
hardware, system software, interfaces and operations with other entity such as the Department of Health (DOH).
4. What is the role of the medical support system?

a. It directly assists health care providers in interpretation of data and in making clinically related decisions
b. It improves hospital inventory management
c. It controls the spread of diseases to a certain environment
d. All of the above.
ANSWER: A
RATIO: Medical Support System directly assist health care providers in interpretation of data and in making clinically related
decision. A clinical decision support system (CDSS) is a health information technology, provides clinicians, staff, patients,
or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times,
to enhance health and health care.
5. All of the statements below define the Laboratory Information System except:
a. The laboratory information system supports both processing of data associated with laboratory tests and
management functions associated with day to day operations.
b. The laboratory information system has a management system which tracks samples, integrates instruments
and manages various laboratory functions.
c. The laboratory information system prioritizing and viewing of work, generating of reports and ensuring
compliance with government regulations and corporate standards.
d. The laboratory information system provides repeated and continuous observations and/or measurements
of a patient's psychological condition through statistical processes by collecting, storing and processing
patient’s data and other input data (physician, pharmacy, dietary, finance, etc).
ANSWER: D
RATIO: Choice D defines the patient monitoring system.
6. The goal of nursing informatics is ______
a. to improve health by optimizing information management and communication
b. to streamline nurses work and promote the use of non-licensed personnel.
c. to provide a scientific basis for nursing practice
d. to identify and quantify nursing intervention.
ANSWER: A
RATIO: While more technical than other nursing careers, the main goal of nursing informatics is enhancing patient care.
Better information systems and data mean fewer medical errors and better handling of patient data.
7. Refers to a nurse informaticist that develops and implements educational materials and educational sessions about
system to employees
a. Liaison c. Educator
b. Project manager d. System analyst
ANSWER: C
RATIO: Nursing informatics educators are essential to the nursing, medical, and clinical fields, combining a love of medicine,
educating others, and technology to empower caregivers. They educate other nurses, medical providers, and health care
workers on how to use clinical information systems and work towards improving these systems to improve patient outcomes.
Many places, such as hospitals, behavioral health offices, and family practices, hire nursing informatics educators, to name
a few.
8. Refers to a nurse informaticist that analyzes nursing information needs and develops market solutions a.
Advocate
b. Researcher
c. Consultant
d. Entrepreneur
ANSWER: D
RATIO: Nurse entrepreneurs may build their businesses to develop and distribute medical products or devices, offer direct
patient care or patient advocacy, educate or train other professionals or community members, or provide health care-related
consultation, among other functions.
9. What level does a nurse informaticist belong if she possesses basic information management and computer
technology skills?
a. Beginning nurse
b. Experienced nurse
c. Informatics nurse specialist
d. Innovative nurse
ANSWER: A
RATIO: The beginning nurse/first level of informatics competencies for practicing nurses should possess basic information
management and computer technology skills. Accomplishments should include the ability to access data, use a computer
for communication, use basic desktop software and use decision support systems.
10. A set of cognitive processes that allows the individual to recognize what, when and where information is needed
and to locate, evaluate and use that information appropriately.
a. Computer Literacy
b. Informatics Knowledge
c. Informatics skill
d. None of the above
ANSWER: B
RATIO: Informatics knowledge is a set of cognitive processes that allows the individual to recognize what, when and where
information is needed and to locate, evaluate and use that information appropriately. Informatics knowledge refers to the
knowledge to use computer technologies to deploy information sciences. In addition, informatics skills can be defined as
the skills to implement instructions, tools and specific methods in informatics (Staggers et al., 2002).
LESSON WRAP-UP
AL Activity: STOP SUMMARY
This strategy provides a structure for you to record your own comprehension and summarize your learning. Complete the
following sentences:
Started the lesson with recalling the benefits of computer-based patient health records.
Topic was about the Clinical and Health Information System and Nurse Informaticist & The Nurse Entrepreneur.
Our Opportunities for practice was about learning the implementation of computer-based patent health records since we
can apply and use it during our duties.
Purpose of the lesson was to explain the importance of clinical and hospital information system, state the benefits of
Computer–based patient health records, explain on how to handle computer threats and viruses, describe Information
Process Flow with Clinical and Hospital Information System, determine the goal and metastructure of nursing informatics,
differentiate nurse informatics from nurse entrepreneur, describe the role of a nurse informatics and the nurse entrepreneur;
and, identify the levels of informatics competencies of a nurse.

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Nursing Info - Sas16 23

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Nursing Informatics

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

LESSON TITLE: INFORMATICS APPLICATIONS IN Materials:

LEARNING OUTCOMES: References:

COMPUTER GENERATED NURSING CARE PLANS

● Distinct characteristics of Nursing Process

CHECK FOR UNDERSTANDING

6. Which of the following is a distinct characteristic of the nursing process?

9. Which of the following are ways of improving critical thinking?

Fill up the following grids:

• The Nursing Process

W WHAT I WANT TO KNOW

• Computer Generated Nursing Care Plans

LESSON TITLE: Materials:

At the end of the lesson, you can:

• Computer Information System

● Guideline development has four stages:

● Eleven characteristics of the guidelines:

What is evidence based practice in nursing journals?

Types or Variants of E-journals:

Current Clinical Practice

Managing Patient Records-Computerized Database: Managing Patient Records-Computerized Database ●

Application to Nursing Practice

Electronic Medical Record System

How is telemedicine used?

What are the subspecialties of telemedicine?

Other uses of Telemedicine

2. What is the first stage of developing a guideline?

7. Which type of records contain the most information?

a. Evidence base records c. Patient portal

9. Which of the following is a significant benefit of telemedicine?

10. What is the oldest form of telemedicine?

AL Activity: CAT 3-2-1

Three things you learned:

1. Four stages of guideline development.

3. Types or variants of E-journals.

One question you still have:

LESSON TITLE: APPLICATION OF HEALTH INFORMATICS Materials:

LEARNING OUTCOMES: References:

MANAGEMENT INFORMATION SYSTEM IN HEALTH CARE

● System- A collection of components that work together to achieve a common objective

− Patient Care − Legal Documentation

● Content of Patient Records

HEALTH INFORMATION PROFESSIONALS

GENERAL APPLICATION SOFTWARE FOR NURSE LEADERS

7. What is the goal of the nursing information system?

8. Which of the following is a disadvantage of nursing information systems?

AL Activity: DAILY DOZEN

LESSON TITLE: EDUCATION Materials:

At the end of the lesson, you can:

How does this relate to what you already know

- I think the pictures presented depicts on how

NURSING EDUCATION IN THE PAST

CURRENT NURSING EDUCATION

CLINICAL SIMULATION: LOW FIDELITY SIMULATORS

NURSING CARE CONFERENCE

LEARNING IN DIGITAL AGE

HIGH FIDELITY SIMULATORS: HIGH FIDELITY SIMULATORS